Provider Demographics
NPI:1649406158
Name:DEAL, ANNETTE HOPE
Entity Type:Individual
Prefix:
First Name:ANNETTE
Middle Name:HOPE
Last Name:DEAL
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 1:1404 HILLMONT DR
Mailing Address - Street 2:
Mailing Address - City:KINGSPORT
Mailing Address - State:TN
Mailing Address - Zip Code:37660-1324
Mailing Address - Country:US
Mailing Address - Phone:423-502-4194
Mailing Address - Fax:423-246-1327
Practice Address - Street 1:1404 HILLMONT DR
Practice Address - Street 2:
Practice Address - City:KINGSPORT
Practice Address - State:TN
Practice Address - Zip Code:37660-1324
Practice Address - Country:US
Practice Address - Phone:423-502-4194
Practice Address - Fax:423-246-1327
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-10
Last Update Date:2009-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNRN0000122696163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management