Provider Demographics
NPI:1326311895
Name:MCDUFFIE, DEANDRA (DNP, NP-C)
Entity Type:Individual
Prefix:DR
First Name:DEANDRA
Middle Name:
Last Name:MCDUFFIE
Suffix:
Gender:F
Credentials:DNP, NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1550 JANMAR RD STE B
Mailing Address - Street 2:
Mailing Address - City:SNELLVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30078-5779
Mailing Address - Country:US
Mailing Address - Phone:770-822-3031
Mailing Address - Fax:
Practice Address - Street 1:771 OLD NORCROSS RD STE 225
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30046-4982
Practice Address - Country:US
Practice Address - Phone:678-802-4045
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-02-14
Last Update Date:2024-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN208108363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner