Provider Demographics
NPI:1942875679
Name:DECK, DIANNE SAKONYI (ACNP)
Entity Type:Individual
Prefix:MS
First Name:DIANNE
Middle Name:SAKONYI
Last Name:DECK
Suffix:
Gender:F
Credentials:ACNP
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Mailing Address - Street 1:PO BOX 60352
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63160-0352
Mailing Address - Country:US
Mailing Address - Phone:314-454-8917
Mailing Address - Fax:314-747-2200
Practice Address - Street 1:4921 PARKVIEW PL
Practice Address - Street 2:DIV IM PULMONARY, STE 8B
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63110-1032
Practice Address - Country:US
Practice Address - Phone:314-454-8917
Practice Address - Fax:314-747-2200
Is Sole Proprietor?:No
Enumeration Date:2021-05-25
Last Update Date:2024-04-25
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MO2019034473363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO420118998Medicaid