Individual
LUANN DEAFENBAUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
7910 W JEFFERSON BLVD STE 108, FORT WAYNE, IN 46804-4159
(260) 436-0800
(260) 483-1911
Mailing address
PO BOX 749495, ATLANTA, GA 30374-9495
(855) 963-2100
(239) 236-2775
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
71002903A
IN
363LF0000X
Family Nurse Practitioner
28067608
IN
Other
Enumeration date
04/01/2009
Last updated
12/18/2024
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