Teri E Deane, CREDENTIALED SN

Individual provider Active NPI School Registered Nurse · Benicia, CA

NPI 1700370285 · NPPES record last updated Jun 19, 2018

Key facts

NPI
1700370285
Entity type
Individual (NPI type 1)
Primary specialty
School Registered Nurse 163WS0200X
License
456131 (CA)
Practice address
350 E K St
Benicia, CA 94510-3437
Phone
(707) 748-2624
Fax
(707) 746-6152
NPI assigned
Jun 19, 2018
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

State licenses

LicenseStateTypeSpecialty
456131CAMDSchool Registered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
School Registered Nurse 163WS0200X 456131 CA Yes

Addresses

Primary practice location

350 E K St
Benicia, CA 94510-3437

Mailing address

350 E K St Ste 7
Benicia, CA 94510-3437
Phone (707) 748-2624

Other providers in Benicia, CA

All providers in Benicia, CA · School Registered Nurse in California

Sources for this page

Verify at the official NPI Registry.