Individual
DEANDRA RENEE SUTHERLAND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
861 WESLEY ST, NORTH BALDWIN, NY 11510-1433
(718) 807-8479
Mailing address
861 WESLEY ST, NORTH BALDWIN, NY 11510-1433
(718) 807-8479
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
604519
NY
363LF0000X
Family Nurse Practitioner
Primary
339860
NY
Other
Enumeration date
08/23/2016
Last updated
08/24/2016
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