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General NPI Number Information
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NPI Number | 1841328333
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Entity Type | Individual
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Provider Name | DELAINE MCGAHA APRN, BC, MAC,
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Gender | Female
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Dates
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Enumeration Date | 02/28/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 4 E MOORE ST
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City | STATESBORO
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State | GA
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Zip | 30458-4590
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Country | US
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Telephone | 912-764-5049
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Fax |
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Provider Business Mailing Address
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Address Line | 4 E MOORE ST
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City | STATESBORO
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State | GA
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Zip | 30458-4590
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Country | US
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Telephone | 912-764-5049
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | GA057561
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License Number State | GA
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