Provider Demographics
NPI:1427466416
Name:CAZA, DEANNA (RPH)
Entity type:Individual
Prefix:
First Name:DEANNA
Middle Name:
Last Name:CAZA
Suffix:
Gender:F
Credentials:RPH
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 306
Mailing Address - Street 2:121 MAIN ST E
Mailing Address - City:HINCKLEY
Mailing Address - State:MN
Mailing Address - Zip Code:55037-0306
Mailing Address - Country:US
Mailing Address - Phone:320-384-6166
Mailing Address - Fax:320-384-0016
Practice Address - Street 1:121 MAIN ST E
Practice Address - Street 2:PB 130
Practice Address - City:HINCKLEY
Practice Address - State:MN
Practice Address - Zip Code:55037-0306
Practice Address - Country:US
Practice Address - Phone:320-384-6166
Practice Address - Fax:320-384-0016
Is Sole Proprietor?:No
Enumeration Date:2014-07-23
Last Update Date:2014-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN115044183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist