Provider Demographics
NPI:1598878886
Name:MANN, DEANNA LORRIE (NP)
Entity Type:Individual
Prefix:
First Name:DEANNA
Middle Name:LORRIE
Last Name:MANN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:1691 THE ALAMEDA
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95126-2203
Mailing Address - Country:US
Mailing Address - Phone:408-287-7532
Mailing Address - Fax:408-287-0405
Practice Address - Street 1:604 E EVELYN AVE
Practice Address - Street 2:
Practice Address - City:SUNNYVALE
Practice Address - State:CA
Practice Address - Zip Code:94086-6459
Practice Address - Country:US
Practice Address - Phone:408-739-5258
Practice Address - Fax:408-992-0627
Is Sole Proprietor?:No
Enumeration Date:2006-08-17
Last Update Date:2007-07-25
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CARN258056363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health