Provider Demographics
NPI:1851643076
Name:CURRY, DEIDRA (NP)
Entity Type:Individual
Prefix:
First Name:DEIDRA
Middle Name:
Last Name:CURRY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6030 S 085 W
Mailing Address - Street 2:
Mailing Address - City:WOLCOTTVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46795-8972
Mailing Address - Country:US
Mailing Address - Phone:219-964-8088
Mailing Address - Fax:
Practice Address - Street 1:6279 E STATE BLVD
Practice Address - Street 2:
Practice Address - City:FORT WAYNE
Practice Address - State:IN
Practice Address - Zip Code:46815
Practice Address - Country:US
Practice Address - Phone:260-492-0951
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-11
Last Update Date:2018-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28189331A163W00000X
IN71004189A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse