Provider Demographics
NPI:1710729090
Name:REICH, DEENA B STIEFEL (RN CLC)
Entity type:Individual
Prefix:
First Name:DEENA
Middle Name:B STIEFEL
Last Name:REICH
Suffix:
Gender:F
Credentials:RN CLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6790 JARDIN PL
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33433-2345
Mailing Address - Country:US
Mailing Address - Phone:404-368-5529
Mailing Address - Fax:
Practice Address - Street 1:6790 JARDIN PL
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33433-2345
Practice Address - Country:US
Practice Address - Phone:404-368-5529
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-08
Last Update Date:2024-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY778788163W00000X
FLRN9609151163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant
No163W00000XNursing Service ProvidersRegistered Nurse