Massie, Deanna L.

Massie, Deanna L. is an individual health care provider with primary practice located at 7910 W Jefferson Blvd Ste 112 , Fort Wayne IN 46804-4159. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Clinical Nurse Specialist, which is considered as her primary health care specialty. Massie, Deanna L. can be contacted via phone (260) 969-7121.

Contact Information

Primary practice address
7910 W Jefferson Blvd Ste 112 Fort Wayne IN 46804-4159
Phone: (260) 969-7121
Fax: (260) 407-4330
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Clinical Nurse Specialist 364S00000X 71003492A Indiana

Profile Details

NPI number 1205117454
LBN Legal business name Massie, Deanna L.
Credentials Clinical Nurse Specialist (CNS)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 1st, 2011
Last updated Sep 29th, 2020 - about 6 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 1205117454 NPPES
Indiana Other P01102663 RAILROAD MEDICARE
Indiana MEDICAID 201031980 RAILROAD MEDICARE
Indiana MEDICAID 0070146 RAILROAD MEDICARE

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