Provider Demographics
NPI:1598747248
Name:DUKES, DEANNA MAY (APRN)
Entity Type:Individual
Prefix:MS
First Name:DEANNA
Middle Name:MAY
Last Name:DUKES
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:MS
Other - First Name:DEANNA
Other - Middle Name:MAY
Other - Last Name:REDDICK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP
Mailing Address - Street 1:2501 N ORANGE AVE STE 542
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32804-4674
Mailing Address - Country:US
Mailing Address - Phone:407-303-5860
Mailing Address - Fax:407-303-2759
Practice Address - Street 1:2501 N ORANGE AVE STE 542
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32804-4674
Practice Address - Country:US
Practice Address - Phone:407-303-5860
Practice Address - Fax:407-303-2759
Is Sole Proprietor?:No
Enumeration Date:2005-11-17
Last Update Date:2020-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN9290786363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
062349Medicare ID - Type Unspecified
P67809Medicare UPIN