Deborah Herndon
Individual provider Active NPI Family Nurse Practitioner · Camilla, GA
NPI 1508305145 · NPPES record last updated Aug 3, 2020
Key facts
- NPI
- 1508305145
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- RN193500 (GA)
- Practice address
- 259 US Highway 19 N
Camilla, GA 31730-1410 - Phone
- (229) 336-1949
- NPI assigned
- Feb 15, 2017
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN193500 | GA | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hospital Authority of the City of Bainbridge and Decatur County | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | RN193500 | GA | Yes |
Addresses
Primary practice location
259 US Highway 19 N
Camilla, GA 31730-1410
Mailing address
900 Cairo Rd
Thomasville, GA 31792-4255
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | deborah.herndon.p2@direct.archbold.nextgenshare.com |
Other providers in Camilla, GA
- Dennis Harpe
- Linda Harris
- Penny Long Harris
- Shuntol Harris
- Tania Harris
- Christopher Cody Hickox
- Davon Hicks
- Randall Leonard Hines Sr.
- Courtney L Hipps
- Janie Holton
All providers in Camilla, GA · Family Nurse Practitioner in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 3, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.