Provider Demographics
NPI:1902973001
Name:DEWITT, DEBRA MORGAN (APRN BC)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:MORGAN
Last Name:DEWITT
Suffix:
Gender:F
Credentials:APRN BC
Other - Prefix:
Other - First Name:DEBRA
Other - Middle Name:ROSE
Other - Last Name:DEWITT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:10 PARK PLACE SOUTH, SE
Mailing Address - Street 2:FULTON COUNTY BOARD OF HEALTH SE, SUITE 445
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30303
Mailing Address - Country:US
Mailing Address - Phone:404-613-1205
Mailing Address - Fax:404-612-2285
Practice Address - Street 1:265 BOULEVARD
Practice Address - Street 2:4TH FLOOR THE CENTER FOR HEALTH AND REHABILITATION
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30312
Practice Address - Country:US
Practice Address - Phone:404-612-1649
Practice Address - Fax:404-893-6293
Is Sole Proprietor?:No
Enumeration Date:2006-11-30
Last Update Date:2017-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN110136363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner