Wanda Jane Dedeaux in Pascagoula - Family
Wanda Jane Dedeaux - NPI 1639171234
Wanda Jane Dedeaux is a Family in Pascagoula, Mississippi. Wanda Jane Dedeaux practices all healthcare services and medical treatments related to Family. The NPI Number for Wanda Jane Dedeaux is 1639171234. The last update date is 2007-07-08.
Wanda Jane Dedeaux's current location address is 1820 Old Mobile Ave, Pascagoula, Mississippi. You can contact this provider via phone number 2286960230 and fax number 2287122374. The mailing address for Wanda Jane Dedeaux is 1820 Old Mobile Ave, Pascagoula, Mississippi. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Wanda Jane Dedeaux |
|---|---|
| Address | 1820 Old Mobile Ave, Pascagoula, Mississippi |
| Phone Number | 2286960230 |
| Fax Number | 2287122374 |
| Sole Proprietor | N |
| Credentials | FNP |
NPI Number Detail
| NPI Number | 1639171234 |
|---|---|
| Provider Enumeration Date | 2005-08-12 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 1820 Old Mobile Ave |
|---|---|
| City | Pascagoula |
| State | Mississippi (MS) |
| Post Code | 395674412 |
| Phone Number | 2286960230 |
| Fax Number | 2287122374 |
Provider's Primary Taxonomy Detail
| Speciality | Family |
|---|---|
| Taxonomy | 363Lf0000X |
| Licence No | R744414 |
|
Definition: An advanced practice registered nurse expert in primary healthcare for patients of all ages. |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 120206 | MS | -- |
Post Comment/ Review Below
What is the Wanda Jane Dedeaux's 1639171234?
The Wanda Jane Dedeaux's NPI (National Provider Identifier) Number is 1639171234. This unique 10-digit identification number is assigned to health care providers by the Centers for Medicare & Medicaid Services (CMS).
Could you please share the complete physical location address where Wanda Jane Dedeaux's facilities are situated?
The facilities of Wanda Jane Dedeaux are physically located at the following address: 1820 Old Mobile Ave, Pascagoula, MS, 395674412.
What is the Wanda Jane Dedeaux's area of specialization and corresponding taxonomy classification?
The Wanda Jane Dedeaux's specialty field is Family, and it falls under the taxonomy code 363Lf0000X, which categorizes healthcare providers based on their specialties.
On what date did the Centers for Medicare & Medicaid Services issue the 1639171234 to Wanda Jane Dedeaux?
The Wanda Jane Dedeaux received its 1639171234 assignment from the Centers for Medicare & Medicaid Services on 2005-08-12.
When was the information regarding Wanda Jane Dedeaux most recently updated?
The details pertaining to the Wanda Jane Dedeaux, including its address, specialty, and other relevant information, were last refreshed on 2007-07-08.