Provider Demographics
NPI:1740422054
Name:SUAZO, DEANA LOUISE (HOME CARE PROVIDER)
Entity Type:Individual
Prefix:MISS
First Name:DEANA
Middle Name:LOUISE
Last Name:SUAZO
Suffix:
Gender:F
Credentials:HOME CARE PROVIDER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10881 E. 96 PLACE
Mailing Address - Street 2:
Mailing Address - City:COMMERCE CITY
Mailing Address - State:CO
Mailing Address - Zip Code:80022
Mailing Address - Country:US
Mailing Address - Phone:303-286-2566
Mailing Address - Fax:303-288-2196
Practice Address - Street 1:10881 E. 96 PLACE
Practice Address - Street 2:
Practice Address - City:COMMERCE CITY
Practice Address - State:CO
Practice Address - Zip Code:80022
Practice Address - Country:US
Practice Address - Phone:303-286-2566
Practice Address - Fax:303-288-2196
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-01
Last Update Date:2009-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide