Deanna Fredericks Harless, ACNP

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

RN054166 AP03616 Issued in LA

Practice address

1614 Wolf Cir
Lake Charles, LA 70605-2348

Phone

(337) 478-9653

Fax

(337) 474-0988

NPI assigned

Jun 24, 2005

Last updated

Dec 16, 2009By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in LA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

• Geriatric Resources, Inc

  • Geriatric Medicine (Family Medicine) Physician
  • Lake Charles, LA
  • NPI 1700052958
  Medicare reassignment

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1119571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1260921600000",
    "number": "1407852288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1786",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706021786",
            "telephone_number": "337-478-9653",
            "fax_number": "337-474-0988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1614 WOLF CIR",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706052348",
            "telephone_number": "337-478-9653",
            "fax_number": "337-474-0988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARLESS",
        "first_name": "DEANNA",
        "middle_name": "FREDERICKS",
        "credential": "ACNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-06-24",
        "last_updated": "2009-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "LA",
            "license": "RN054166 AP03616",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1436461",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ross Hardy, M.D.
• Theresa Marie Hardy, PHD
• Vanessa Hardy, RD
• Shea Ledoux Hare, PA-C
• James Hargrove
• Patrick Wilton Harlow Jr., LPC
• Felicia Renee Harmon-Richardson, M.S., PLMFT
• Damika Renee' Harmon, DNP, APRN, NP-C
• Fallon Harmon
• Keylon Harmon

• Acute Care Nurse Practitioner in Lake Charles, LA
• Providers in Lake Charles, LA by specialty
• Acute Care Nurse Practitioner in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.