Deanna Marie Spears, LPN – Licensed Practical Nurse

Key facts

NPI: 1245552108
Entity type: Individual (NPI type 1)
Primary specialty: Licensed Practical Nurse 164W00000X
License: 288131-1 (NY)
Practice address: 1500 Dayspring RDG
Walworth, NY 14568-9517
Phone: (315) 986-3521
NPI assigned: Feb 19, 2010
Sex: Female
Sole proprietor: Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Gananda Central School District Local Education Agency (LEA) · Walworth, NY · NPI 1790842649

NPD (past)

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): No

State licenses

License	State	Type	Specialty
288131-1	NY	MD	Licensed Practical Nurse

Practice roles

Organization	Specialty	Status	New patients
Gananda Central School District		Past since Nov 20, 2022	Accepting new patients

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Licensed Practical Nurse	164W00000X	288131-1	NY	Yes

Addresses

Primary practice location

1500 Dayspring RDG
Walworth, NY 14568-9517

Mailing address

966 Summitville Dr
Webster, NY 14580-4133
Phone (585) 278-4162

Other names

Mrs. Deanna Marie Hendricks Other name

Other providers in Walworth, NY

All providers in Walworth, NY · Licensed Practical Nurse in New York

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 18, 2022. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.