Provider Demographics
NPI:1861015182
Name:DENMEADE, DYAN ELIZABETH (APRN-CNP)
Entity Type:Individual
Prefix:MRS
First Name:DYAN
Middle Name:ELIZABETH
Last Name:DENMEADE
Suffix:
Gender:F
Credentials:APRN-CNP
Other - Prefix:
Other - First Name:DYAN
Other - Middle Name:ELIZABETH
Other - Last Name:HAMERCHECK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:370 S TOUSSAINT PORTAGE RD
Mailing Address - Street 2:
Mailing Address - City:OAK HARBOR
Mailing Address - State:OH
Mailing Address - Zip Code:43449-9405
Mailing Address - Country:US
Mailing Address - Phone:440-622-0654
Mailing Address - Fax:
Practice Address - Street 1:370 S TOUSSAINT PORTAGE RD
Practice Address - Street 2:
Practice Address - City:OAK HARBOR
Practice Address - State:OH
Practice Address - Zip Code:43449-9405
Practice Address - Country:US
Practice Address - Phone:440-622-0654
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-20
Last Update Date:2020-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0026812363L00000X
OH423704163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse