Deanna Fay Harris
Individual provider Active NPI Driver · Dillwyn, VA
NPI 1508536798 · NPPES record last updated Sep 17, 2021
Key facts
- NPI
- 1508536798
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Driver 172A00000X
- Practice address
- 212 Roachs LN
Dillwyn, VA 23936-3075 - Phone
- (143) 431-5308
- NPI assigned
- Sep 17, 2021
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Driver | 172A00000X | VA | Yes |
Addresses
Primary practice location
212 Roachs LN
Dillwyn, VA 23936-3075
Mailing address
212 Roachs LN
Dillwyn, VA 23936-3075
Phone (434) 315-3084
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 842040380 | Medicaid | VA |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | location | Direct |
Other providers in Dillwyn, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 17, 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.