Provider Demographics
NPI:1750703542
Name:ALBANESE, DEIDRE LYNN (CRNP)
Entity type:Individual
Prefix:
First Name:DEIDRE
Middle Name:LYNN
Last Name:ALBANESE
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:95 LEONARD AVE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:15301-3368
Mailing Address - Country:US
Mailing Address - Phone:724-229-1344
Mailing Address - Fax:724-229-1347
Practice Address - Street 1:95 LEONARD AVE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:PA
Practice Address - Zip Code:15301-3368
Practice Address - Country:US
Practice Address - Phone:724-229-1344
Practice Address - Fax:724-229-1347
Is Sole Proprietor?:No
Enumeration Date:2014-01-13
Last Update Date:2018-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH17520363LF0000X
PASP013604363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily