Provider Demographics
NPI:1467933457
Name:HANSELL, DEANNA S
Entity Type:Individual
Prefix:
First Name:DEANNA
Middle Name:S
Last Name:HANSELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2822 SUNNYSIDE ST
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32254-4358
Mailing Address - Country:US
Mailing Address - Phone:904-862-5855
Mailing Address - Fax:
Practice Address - Street 1:2822 SUNNYSIDE ST
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32254-4358
Practice Address - Country:US
Practice Address - Phone:904-862-5855
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-27
Last Update Date:2018-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes376J00000XNursing Service Related ProvidersHomemakerGroup - Multi-Specialty