Individual
KATHERINE POWE DEAVERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, MS, FNP
Contact information
Practice address
655 JESSE JEWELL PKWY SE, GAINESVILLE, GA 30501-3756
(678) 207-4500
(770) 536-0383
Mailing address
PO BOX 658, GAINESVILLE, GA 30503-0658
(770) 718-1122
(770) 535-7445
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
RN100964
GA
363LF0000X
Family Nurse Practitioner
Primary
APRN-NP100964
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01341907
AMERIGROUP
GA
01
—
571471
WELLCARE
GA
05
—
738974330B
—
GA
05
—
738974330C
—
GA
01
—
P00847058
MEDICARE RAILROAD
GA
Enumeration date
12/02/2005
Last updated
10/30/2025
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