Qiana Depp, AESTHETICIAN

Primary specialty

Procedural Dermatology PhysicianTaxonomy code 207NS0135X

License

ESTE-17064 Issued in OH

Practice address

6924 Spring Valley Dr # 160
Holland, OH 43528-9482

Phone

(419) 322-0567

NPI assigned

Jul 20, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1500508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1500508800000",
    "number": "1992228183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6924 SPRING VALLEY DR # 160",
            "city": "HOLLAND",
            "state": "OH",
            "postal_code": "435289482"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6924 SPRING VALLEY DR # 160",
            "city": "HOLLAND",
            "state": "OH",
            "postal_code": "435289482",
            "telephone_number": "419-322-0567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEPP",
        "first_name": "QIANA",
        "credential": "AESTHETICIAN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-07-20",
        "last_updated": "2017-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207NS0135X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "OH",
            "license": "ESTE-170641",
            "primary": false
        },
        {
            "code": "207NS0135X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "OH",
            "license": "ESTE-17064",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alex Davis
• Cody R Dearing, BA, CDCA
• David Charles Decker
• Lisa Delas
• Teresa Nickole Dennis
• Ciara Latavia Dickerson
• Diterlizzi Dental, LLC
• Vy T DO, LISW-S
• Randall Ryan Domby
• Erich Donati, CDCA

• Procedural Dermatology Physician in Holland, OH
• Providers in Holland, OH by specialty
• Procedural Dermatology Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.