Individual
MS. DESHAWN LATRICE VINES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
53 SCHOOL ST APT 4F, BEDFORD HILLS, NY 10507-1918
(347) 419-6860
Mailing address
53 SCHOOL ST APT 4F, BEDFORD HILLS, NY 10507-1918
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
N09032-01
NY
207QG0300X
Geriatric Medicine (Family Medicine) Physician
N09032-01
NY
282N00000X
General Acute Care Hospital
N09032-01
NY
Other
Enumeration date
12/11/2025
Last updated
12/11/2025
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