Rodenberg, Deanna L.

Rodenberg, Deanna L. is an individual health care provider with primary practice located at 4550 Memorial Dr Ste. 340, Belleville IL 62226-5372. She recently has 3 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Family, Nursing Service Providers / Registered Nurse, Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner. Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner is her primary health care specialty. Rodenberg, Deanna L. can be contacted via phone (618) 257-6200.

Contact Information

Primary practice address
4550 Memorial Dr Ste. 340 Belleville IL 62226-5372
Phone: (618) 257-6200
Fax: (618) 257-6679
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 2012025805 Missouri
Nursing Service Providers / Registered Nurse 163W00000X 041404382 Illinois
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 209009887 Illinois

Profile Details

NPI number 1013265248
LBN Legal business name Rodenberg, Deanna L.
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 20th, 2012
Last updated Feb 8th, 2014 - about 10 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 1013265248 NPPES
Illinois Other 209009887 APN
Illinois Other 041404382 APN

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