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General NPI Number Information
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NPI Number | 1912266925
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Entity Type | Individual
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Provider Name | FTYNA M DEARRING FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 05/10/2012
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Last Update Date | 03/14/2025
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Provider Practice Location Address
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Address Line | 16110 E 14TH ST
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City | SAN LEANDRO
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State | CA
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Zip | 94578-3002
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Country | US
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Telephone | 510-471-5880
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Fax |
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Provider Business Mailing Address
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Address Line | 216 HARVEST DR
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City | ROCHESTER
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State | NY
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Zip | 14626-1330
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Country | US
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Telephone | 585-802-4649
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | F336779-1
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | NP95028926
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License Number State | CA
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