Provider Demographics
NPI:1205158441
Name:DEPUGH, DEANNA (CNP)
Entity type:Individual
Prefix:MRS
First Name:DEANNA
Middle Name:
Last Name:DEPUGH
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:445 N HIGH ST
Mailing Address - Street 2:445 1/2 IS SIDE OFFICE
Mailing Address - City:CHILLICOTHE
Mailing Address - State:OH
Mailing Address - Zip Code:45601
Mailing Address - Country:US
Mailing Address - Phone:740-327-0400
Mailing Address - Fax:740-327-0500
Practice Address - Street 1:445 N HIGH ST
Practice Address - Street 2:445 1/2 IS SIDE OFFICE
Practice Address - City:CHILLICOTHE
Practice Address - State:OH
Practice Address - Zip Code:45601
Practice Address - Country:US
Practice Address - Phone:740-327-0400
Practice Address - Fax:740-327-0500
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-15
Last Update Date:2024-05-15
Deactivation Date:2018-12-19
Deactivation Code:
Reactivation Date:2019-01-17
Provider Licenses
StateLicense IDTaxonomies
OHRN.385441163W00000X
OHAPRN.CNP.024108363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse