Fordham, Deananne D
Fordham, Deananne D is an individual health care provider with primary practice located at 1223 Plaza Ave , Eastman GA 31023-6763. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Medical, which is considered as her primary health care specialty. Fordham, Deananne D can be contacted via phone (478) 374-3814.Contact Information
Primary practice address
1223 Plaza Ave
Eastman GA 31023-6763
Phone: (478) 374-3814
Fax: (478) 374-1478
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Medical | 363AM0700X | 003393 | Georgia |
Profile Details
| NPI number | 1215904446 |
|---|---|
| LBN Legal business name | Fordham, Deananne D |
| Credentials | PAC |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 7th, 2006 |
| Last updated | Jul 9th, 2007 - about 18 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 | 1215904446 | NPPES |
| Georgia | MEDICAID | 100001203A |
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