Provider Demographics
NPI:1699423335
Name:DEUZ, NICK DAVID (MSN, RN, CPNP-AC)
Entity type:Individual
Prefix:
First Name:NICK
Middle Name:DAVID
Last Name:DEUZ
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Gender:M
Credentials:MSN, RN, CPNP-AC
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Mailing Address - Street 1:3008 94TH ST
Mailing Address - Street 2:
Mailing Address - City:EAST ELMHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11369-1720
Mailing Address - Country:US
Mailing Address - Phone:347-820-8007
Mailing Address - Fax:
Practice Address - Street 1:2315 STOCKTON BLVD
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95817-2201
Practice Address - Country:US
Practice Address - Phone:347-820-8007
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-11
Last Update Date:2024-01-12
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PASP025476363LP0200X
NYF383437-01363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics