Provider Demographics
NPI:1043084700
Name:GARVEY, DEANNA (NP-C)
Entity type:Individual
Prefix:
First Name:DEANNA
Middle Name:
Last Name:GARVEY
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:471 PAOLI AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19128-4346
Mailing Address - Country:US
Mailing Address - Phone:215-906-1335
Mailing Address - Fax:
Practice Address - Street 1:4092 W SKIPPACK PIKE
Practice Address - Street 2:
Practice Address - City:SKIPPACK
Practice Address - State:PA
Practice Address - Zip Code:19474
Practice Address - Country:US
Practice Address - Phone:215-792-3884
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-13
Last Update Date:2023-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DELG-0012554363LF0000X
PASP028600363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily