Provider Demographics
NPI:1932796513
Name:EARLEY, DEAUNNA
Entity Type:Individual
Prefix:
First Name:DEAUNNA
Middle Name:
Last Name:EARLEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4722 CLEVELAND AVE NW APT 2
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44709-1844
Mailing Address - Country:US
Mailing Address - Phone:330-481-0595
Mailing Address - Fax:
Practice Address - Street 1:4722 CLEVELAND AVE NW APT 2
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44709-1844
Practice Address - Country:US
Practice Address - Phone:330-481-0595
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-29
Last Update Date:2020-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health