Deanna Sutherlin
Individual provider Active NPI Case Manager/Care Coordinator · Fair Oaks, IN
NPI 1366112294 · NPPES record last updated Sep 13, 2021
Key facts
- NPI
- 1366112294
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Case Manager/Care Coordinator 171M00000X
- Practice address
- 2115 E State Road 14
Fair Oaks, IN 47943-8019 - Phone
- (219) 204-1736
- NPI assigned
- Sep 13, 2021
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | Yes |
Addresses
Primary practice location
2115 E State Road 14
Fair Oaks, IN 47943-8019
Mailing address
2115 E State Road 14
Fair Oaks, IN 47943-8019
Phone (219) 204-1736
Other providers in Fair Oaks, IN
All providers in Fair Oaks, IN · Case Manager/Care Coordinator in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 13, 2021. 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.