Dedra Denise Crouse, FNP

Individual provider Active NPI Family Nurse Practitioner · Lebanon, VA

NPI 1801977988 · NPPES record last updated Sep 27, 2012

Key facts

NPI
1801977988
Entity type
Individual (NPI type 1)
Primary specialty
Family Nurse Practitioner 363LF0000X
License
0024166531 (VA)
Practice address
75 Rogers Street
Lebanon, VA 24266
Phone
(276) 889-7621
NPI assigned
Oct 17, 2006
Sex
Female
Sole proprietor
No

Organizations & group practices 6

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.

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Buchanan Health Diabetes Center Past Accepting new patients
Commonwealth of Virginia State Board of Health Past Accepting new patients
Russell County Dental Clinic Past Accepting new patients
Buchanan Health Care LLC Past
since Mar 22, 2004
Accepting new patients
Virginia Department of Health Past Accepting new patients
Portsmouth Anesthesia Associates, P.C. Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 0024166531 VA Yes

Addresses

Primary practice location

75 Rogers Street
Lebanon, VA 24266

Mailing address

PO Box 2347
Lebanon, VA 24266
Phone (276) 889-7621

Other names

  • Dedra Denise Deel Former name

Other providers in Lebanon, VA

All providers in Lebanon, VA · Family Nurse Practitioner in Virginia

Sources for this page

Verify at the official NPI Registry.