Deanna M Wildes
Nurse Practitioner
4750 Waters Avenue Suite 500
Savannah
, Georgia 31404-6261
Deanna M Wildes
Nurse Practitioner
4750 Waters Avenue Suite 500
Savannah
, Georgia 31404-6261
(912) 355-1414
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About
Features
Specialties
- Nurse Practitioner
Languages spoken
- English
Location
First Address
- Deanna M Wildes
- Po Box 116336
- Atlanta, GA
- Zip : 30368-6336
- Fax : (912) 355-1414
- Phone : (912) 352-8346
Second Address
- Deanna M Wildes
- 4750 Waters Avenue Suite 500
- Savannah, GA
- Zip : 31404-6261
- Fax : (912) 355-1414
- Phone : (912) 352-8346
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | RN077963 | GA |
National Provider Identifier
| NPI | 1003199480 |
|---|---|
| Provider Name | Deanna M Wildes |
| First Address | Atlanta, GA 30368-6336 |
| Second Address | Savannah, GA 31404-6261 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 22/09/2011 |
| Last Update Date | 13/02/2019 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 003115053A | (05) | GA |
| 003115053B | (05) | GA |
| 003115053C | (05) | GA |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.