Provider Demographics
NPI:1467457481
Name:QUINN-STEVENSON, DEANNA M (FNP)
Entity Type:Individual
Prefix:
First Name:DEANNA
Middle Name:M
Last Name:QUINN-STEVENSON
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:DEANNA
Other - Middle Name:M
Other - Last Name:QUINN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP
Mailing Address - Street 1:PO BOX 1103
Mailing Address - Street 2:
Mailing Address - City:HARVEY
Mailing Address - State:LA
Mailing Address - Zip Code:70059-1103
Mailing Address - Country:US
Mailing Address - Phone:504-319-1519
Mailing Address - Fax:
Practice Address - Street 1:820 W ESPLANADE AVE
Practice Address - Street 2:
Practice Address - City:KENNER
Practice Address - State:LA
Practice Address - Zip Code:70065-2757
Practice Address - Country:US
Practice Address - Phone:504-340-7031
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-06-16
Last Update Date:2015-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP04524363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA3A182CH07Medicare PIN