Individual
JOAN M DEENER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
3101 BRECKENRIDGE LN, SUITE 1A, LOUISVILLE, KY 40220-2742
(502) 458-7400
(502) 458-7449
Mailing address
3101 BRECKENRIDGE LN, SUITE 1A, LOUISVILLE, KY 40220-2742
(502) 458-7400
(502) 458-7449
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
1030400
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000283599
ANTHEM BLUE SHIELD
KY
01
—
1104961
PASSPORT
KY
01
—
2436422000
PASSPORT ADVANTAGE
KY
01
—
430008599
RAILROAD MEDICARE
KY
05
—
74324948
—
KY
Enumeration date
10/04/2005
Last updated
05/20/2010
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