Harless, Deanna Fredericks

Harless, Deanna Fredericks is an sole proprietor health care provider with primary practice located at 1614 Wolf Cir , Lake Charles LA 70605-2348. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Acute Care, which is considered as her primary health care specialty. Harless, Deanna Fredericks can be contacted via phone (337) 478-9653.

Contact Information

Primary practice address
1614 Wolf Cir Lake Charles LA 70605-2348
Phone: (337) 478-9653
Fax: (337) 474-0988
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Acute Care 363LA2100X RN054166 AP03616 Louisiana

Profile Details

NPI number 1407852288
LBN Legal business name Harless, Deanna Fredericks
Credentials ACNP
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 24th, 2005
Last updated Dec 16th, 2009 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1407852288 NPPES
Louisiana MEDICAID 1436461

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