MEDICARE: MISS DEBORAH S YORK ARPN

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
1	363L00000X	Nurse Practitioner	RN061087	GA

General Provider Information

NPI Number	:	1891834149
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS DEBORAH S YORK ARPN

Provider Business Mailing Address
First Line	:	900 SANDY DUNES
Second Line	:	UNIT # 2
City	:	DALTON
State	:	GA
Zip	:	30721
Country	:	US
Telephone Number	:	706-259-5077
Fax Number	:	706-278-3884

Provider Business Practice Location Address
First Line	:	800 PROFESSIONAL BLVD
Second Line	:
City	:	DALTON
State	:	GA
Zip	:	30720-2536
Country	:	US
Telephone Number	:	706-226-5446
Fax Number	:	706-278-3884

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/05/2007
Last Update Date	:	03/16/2017

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