Provider Demographics
NPI:1760724538
Name:MEALING, DEANNA ALMA (LPN)
Entity Type:Individual
Prefix:
First Name:DEANNA
Middle Name:ALMA
Last Name:MEALING
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:479 AUGUSTINE ST
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14613-1311
Mailing Address - Country:US
Mailing Address - Phone:585-224-5947
Mailing Address - Fax:
Practice Address - Street 1:479 AUGUSTINE ST
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14613-1311
Practice Address - Country:US
Practice Address - Phone:585-224-5947
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-20
Last Update Date:2013-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY264263-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse