Provider Demographics
NPI:1700050424
Name:LAKOTA, DEENA MARIE (CRNP)
Entity Type:Individual
Prefix:
First Name:DEENA
Middle Name:MARIE
Last Name:LAKOTA
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:DEENA
Other - Middle Name:MARIE
Other - Last Name:ROSENBACH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3421 CONCORD RD
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402-9001
Mailing Address - Country:US
Mailing Address - Phone:717-851-4005
Mailing Address - Fax:717-812-2495
Practice Address - Street 1:1001 S GEORGE ST
Practice Address - Street 2:3RD FLOOR
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17403-3676
Practice Address - Country:US
Practice Address - Phone:717-851-4005
Practice Address - Fax:717-812-2495
Is Sole Proprietor?:No
Enumeration Date:2008-04-14
Last Update Date:2022-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP007919363LA2100X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA50076981OtherCAPITAL BLUE CROSS-WMG
PA1571682OtherGATEWAY-WMG
MD927850OtherCAREFIRST MD BCBS
PA2028539OtherHIGHMARK BLUE SHIELD
PA212424OtherJOHNS HOPKINS
MD927850OtherCAREFIRST MD BCBS
PA125525FLTMedicare PIN