Healthcare Provider Details

I. General information

NPI: 1700324779
Provider Name (Legal Business Name): DEANNA PRICE RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/09/2017
Last Update Date: 02/09/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1275 S STATE ST
DOVER DE
19901-6927
US

IV. Provider business mailing address

310 GARNET LN
SMYRNA DE
19977-9647
US

V. Phone/Fax

Practice location:
  • Phone: 302-744-6812
  • Fax:
Mailing address:
  • Phone: 302-222-4877
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WL0100X
TaxonomyLactation Consultant (Registered Nurse)
License Number0023298
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: