DARRELL LEE DEDEAUX NP-C NPI 1023556461

NPI Information

NPI: 1023556461
Provider Name: DARRELL LEE DEDEAUX, NP-C
Classification: Nurse Practitioner - 363LP2300X
Entity Type: Individual

Specialization: Primary Care

PECOS Registration: Yes

Address:
380 KNOLLWOOD ST # 505
WINSTON SALEM, NC
ZIP 27103
Phone: (833) 357-2966
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Darrell Lee Dedeaux, NP-C is a primary care nurse practitioner in Winston Salem, NC. Darrell Lee Dedeaux, NP-C NPI is 1023556461. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

380 KNOLLWOOD ST # 505
WINSTON SALEM, NC
ZIP 27103-884
Phone: (833) 357-2966

The NPI 1023556461 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 2/6/2017 and was last updated on 10/25/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LP2300X	Nurse Practitioner	Primary Care	116077	NORTH CAROLINA	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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