Doctor Name: | DEEPTHY VARGHESE |
NPI Number: | 1194182857 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | N.P. |
License Number: | RN196104 |
Business Practice Address: | 1699 Centerville Dr Buford, GA - 305189236 |
Business Phone Number: | 8452704455 |
Business Fax Number: | |
Mailing Address: | 1699 Centerville Dr, BUFORD |
State: | GA |
Postal Code: | 305189236 |
Phone Number: | 8452704455 |
Fax Number: | |
NPI Enumeration Date: | 01/25/2016 |
NPI Last Update Date: | 01/25/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | RN196104 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | GA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |