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:
Health care specialties
| Specialty | Code | License # | 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 16 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1407852288 | NPPES |
| Louisiana | MEDICAID | 1436461 |
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