Individual
DEANNA JUSTICE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
175 PHILPOTT LN, BEAVER, WV 25813-9501
(304) 254-9262
Mailing address
175 PHILPOTT LN, BEAVER, WV 25813-9501
(304) 254-9262
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
19057
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
19057
LPN LICENSE
WV
Enumeration date
03/28/2022
Last updated
03/28/2022
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