Provider Demographics
NPI:1922456888
Name:CLINE, DEANNA
Entity Type:Individual
Prefix:
First Name:DEANNA
Middle Name:
Last Name:CLINE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:721 E LINCOLNWAY
Mailing Address - Street 2:# 9E
Mailing Address - City:CHEYENNE
Mailing Address - State:WY
Mailing Address - Zip Code:82001-4703
Mailing Address - Country:US
Mailing Address - Phone:334-324-6225
Mailing Address - Fax:
Practice Address - Street 1:721 E LINCOLNWAY
Practice Address - Street 2:# 9E
Practice Address - City:CHEYENNE
Practice Address - State:WY
Practice Address - Zip Code:82001-4703
Practice Address - Country:US
Practice Address - Phone:334-324-6225
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-01
Last Update Date:2017-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator