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NPI Code Detail

MEDICARE: DEBORA JACQUES WHNP

MEDICARE: DEBORA JACQUES WHNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LW0102XWomen's Health Nurse Practitioner288144GA

General Provider Information

NPI Number : 1639026677
Entity Type Code : Individual
Provider Name (Legal Business Name) : DEBORA JACQUES WHNP
Provider Business Mailing Address
First Line : 2500 SHALLOWFORD RD NE APT 8510
Second Line :
City : ATLANTA
State : GA
Zip : 30345-1246
Country : US
Telephone Number : 478-445-5004
Fax Number :
Provider Business Practice Location Address
First Line : 231 W HANCOCK ST
Second Line :
City : MILLEDGEVILLE
State : GA
Zip : 31061-3371
Country : US
Telephone Number : 478-445-5004
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/10/2026
Last Update Date : 03/10/2026

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