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Individual
DEBORAH SHADBURN
Active
Individual
DEBORAH SHADBURN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
RN051454
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000733268A
—
GA
05
—
000733268B
—
GA
05
—
000733268E
—
GA
05
—
000733268F
—
GA
01
—
10032995
AMERIGROUP
GA
01
—
303674
WELLCARE
GA
01
—
303687
WELLCARE
GA
01
—
303688
WELLCARE
GA
01
—
303689
WELLCARE
GA
Enumeration date
02/03/2006
Last updated
08/16/2011
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