Evans, Deborah
Evans, Deborah is an individual health care provider with primary practice located at 2400 Mount Zion Pkwy Kaiser Permanente Southwood Medical Center, Jonesboro GA 30236-2500. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, Physician Assistants & Advanced Practice Nursing Providers / Medical. Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant is her primary health care specialty. Evans, Deborah can be contacted via phone (404) 851-8000.Contact Information
Primary practice address
2400 Mount Zion Pkwy Kaiser Permanente Southwood Medical Center
Jonesboro GA 30236-2500
Phone: (404) 851-8000
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | 002111 | Georgia |
| Physician Assistants & Advanced Practice Nursing Providers / Medical | 363AM0700X | 002111 | Georgia |
Profile Details
| NPI number | 1881776607 |
|---|---|
| LBN Legal business name | Evans, Deborah |
| Credentials | Physician's Assistant Certified (PA-C) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 20th, 2006 |
| Last updated | Jan 13th, 2022 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1881776607 | NPPES |
| Georgia | MEDICAID | 100001096A | |
| Georgia | Other | 333478 | |
| Georgia | MEDICAID | 100001096 | |
| Georgia | Other | 01067986 | |
| Georgia | MEDICAID | 100001096B |
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