Provider Demographics
NPI:1831945930
Name:DEANER, CAROLYN J
Entity type:Individual
Prefix:MRS
First Name:CAROLYN
Middle Name:J
Last Name:DEANER
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 1:5365 EGYPT RD
Mailing Address - Street 2:
Mailing Address - City:WILLARD
Mailing Address - State:OH
Mailing Address - Zip Code:44890-9541
Mailing Address - Country:US
Mailing Address - Phone:567-224-0934
Mailing Address - Fax:
Practice Address - Street 1:1000 TAMARACK DR
Practice Address - Street 2:
Practice Address - City:WILLARD
Practice Address - State:OH
Practice Address - Zip Code:44890-9329
Practice Address - Country:US
Practice Address - Phone:567-224-0934
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-29
Last Update Date:2024-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker