Provider Demographics
NPI:1740868652
Name:DUDLEY DELEEUW, JANEY
Entity type:Individual
Prefix:
First Name:JANEY
Middle Name:
Last Name:DUDLEY DELEEUW
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JANEY
Other - Middle Name:N
Other - Last Name:DUDLEY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:16 OUIDA CIR
Mailing Address - Street 2:
Mailing Address - City:LONGVIEW
Mailing Address - State:TX
Mailing Address - Zip Code:75603-9611
Mailing Address - Country:US
Mailing Address - Phone:903-576-0538
Mailing Address - Fax:
Practice Address - Street 1:625 19TH STREET SOUTH
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35249-1711
Practice Address - Country:US
Practice Address - Phone:205-638-9100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-31
Last Update Date:2021-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program