Provider Demographics
NPI:1396715488
Name:DUCH, DEANNA (APRN)
Entity type:Individual
Prefix:
First Name:DEANNA
Middle Name:
Last Name:DUCH
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 15645
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89114-5645
Mailing Address - Country:US
Mailing Address - Phone:702-669-5944
Mailing Address - Fax:702-737-5088
Practice Address - Street 1:4475 S EASTERN AVE
Practice Address - Street 2:NEUROLOGY CLINIC
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89119-7826
Practice Address - Country:US
Practice Address - Phone:702-669-5944
Practice Address - Fax:702-737-5088
Is Sole Proprietor?:No
Enumeration Date:2006-01-23
Last Update Date:2025-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV000855363LF0000X
NVAPN000855363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV100506919Medicaid
NV1396715488Medicaid
NVGB909ZMedicare PIN
NVV105909Medicare UPIN
NV100506919Medicaid
Q48661Medicare UPIN