Provider Demographics
NPI:1336444264
Name:DEBLIEUX, DAWNA CHRISTINE (ACNP)
Entity Type:Individual
Prefix:MRS
First Name:DAWNA
Middle Name:CHRISTINE
Last Name:DEBLIEUX
Suffix:
Gender:F
Credentials:ACNP
Other - Prefix:MISS
Other - First Name:DAWNA
Other - Middle Name:CHRISTINE
Other - Last Name:GRAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:501 KEYSER AVE
Mailing Address - Street 2:
Mailing Address - City:NATCHITOCHES
Mailing Address - State:LA
Mailing Address - Zip Code:71457-6018
Mailing Address - Country:US
Mailing Address - Phone:318-214-4470
Mailing Address - Fax:318-214-4462
Practice Address - Street 1:501 KEYSER AVE
Practice Address - Street 2:
Practice Address - City:NATCHITOCHES
Practice Address - State:LA
Practice Address - Zip Code:71457-6018
Practice Address - Country:US
Practice Address - Phone:318-214-4470
Practice Address - Fax:318-214-4462
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-25
Last Update Date:2011-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LARN089347-AP06314363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care