Provider Demographics
NPI:1649829680
Name:ENGELHART, DEANNA MARIE (FNP-C)
Entity type:Individual
Prefix:MISS
First Name:DEANNA
Middle Name:MARIE
Last Name:ENGELHART
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4480 WALLOON CT
Mailing Address - Street 2:
Mailing Address - City:BOYNE CITY
Mailing Address - State:MI
Mailing Address - Zip Code:49712-8828
Mailing Address - Country:US
Mailing Address - Phone:586-850-9668
Mailing Address - Fax:
Practice Address - Street 1:1 HILAND DR
Practice Address - Street 2:
Practice Address - City:PETOSKEY
Practice Address - State:MI
Practice Address - Zip Code:49770-2483
Practice Address - Country:US
Practice Address - Phone:586-850-9668
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-11
Last Update Date:2023-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704304304163W00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse