Shadburn, Deborah
Shadburn, Deborah is an individual health care provider with primary practice located at 725 Jesse Jewell Pkwy Se , Gainesville GA 30501-3834. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Pediatrics, which is considered as her primary health care specialty. Shadburn, Deborah can be contacted via phone (770) 535-3611.Contact Information
Primary practice address
725 Jesse Jewell Pkwy Se
Gainesville GA 30501-3834
Phone: (770) 535-3611
Fax: (770) 535-7092
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Pediatrics | 363LP0200X | RN051454 | Georgia |
Profile Details
| NPI number | 1790757714 |
|---|---|
| LBN Legal business name | Shadburn, Deborah |
| Credentials | Certified Pediatric Nurse Practitioner (CPNP) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 3rd, 2006 |
| Last updated | Aug 16th, 2011 - about 14 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 | 1790757714 | NPPES |
| Georgia | MEDICAID | 000733268E | |
| Georgia | Other | 303687 | |
| Georgia | Other | 303688 | |
| Georgia | Other | 303689 | |
| Georgia | MEDICAID | 000733268F | |
| Georgia | Other | 303674 | |
| Georgia | Other | 10032995 | |
| Georgia | MEDICAID | 000733268A | |
| Georgia | MEDICAID | 000733268B |
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