Provider Demographics
NPI:1063104446
Name:DEINES, CONSTANCE VERLE (NNP)
Entity type:Individual
Prefix:
First Name:CONSTANCE
Middle Name:VERLE
Last Name:DEINES
Suffix:
Gender:F
Credentials:NNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3354 WABASH ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80238-3378
Mailing Address - Country:US
Mailing Address - Phone:720-447-4021
Mailing Address - Fax:
Practice Address - Street 1:3354 WABASH ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80238-3378
Practice Address - Country:US
Practice Address - Phone:720-447-4021
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-23
Last Update Date:2023-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1655307163WN0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WN0002XNursing Service ProvidersRegistered NurseNeonatal Intensive Care