Provider Demographics
NPI:1538332176
Name:NYLAND, DEANNE MARIE (MD)
Entity type:Individual
Prefix:DR
First Name:DEANNE
Middle Name:MARIE
Last Name:NYLAND
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:DEANNE
Other - Middle Name:M
Other - Last Name:ROBERTS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1111 EXPOSITION BLVD BLDG 700
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95815-4314
Mailing Address - Country:US
Mailing Address - Phone:916-736-3399
Mailing Address - Fax:
Practice Address - Street 1:6600 MERCY CT STE 180A
Practice Address - Street 2:
Practice Address - City:FAIR OAKS
Practice Address - State:CA
Practice Address - Zip Code:95628-3198
Practice Address - Country:US
Practice Address - Phone:916-966-2700
Practice Address - Fax:916-966-0749
Is Sole Proprietor?:No
Enumeration Date:2008-04-03
Last Update Date:2024-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA123960207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology