Provider Demographics
NPI:1447691365
Name:KING, DEBORAH A (APRN)
Entity type:Individual
Prefix:MRS
First Name:DEBORAH
Middle Name:A
Last Name:KING
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
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Mailing Address - Street 1:120 STONEBRIDGE PKWY
Mailing Address - Street 2:SUITE 410
Mailing Address - City:WOODSTOCK
Mailing Address - State:GA
Mailing Address - Zip Code:30189-3767
Mailing Address - Country:US
Mailing Address - Phone:770-517-6804
Mailing Address - Fax:770-517-6526
Practice Address - Street 1:120 STONEBRIDGE PKWY
Practice Address - Street 2:SUITE 410
Practice Address - City:WOODSTOCK
Practice Address - State:GA
Practice Address - Zip Code:30189-3767
Practice Address - Country:US
Practice Address - Phone:770-517-6804
Practice Address - Fax:770-517-6526
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-08
Last Update Date:2013-07-12
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GARN123523363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily