Provider Demographics
NPI:1770281396
Name:FINLEY, DEATRA (RN)
Entity type:Individual
Prefix:MS
First Name:DEATRA
Middle Name:
Last Name:FINLEY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4651 HOLT BLVD STE H
Mailing Address - Street 2:
Mailing Address - City:MONTCLAIR
Mailing Address - State:CA
Mailing Address - Zip Code:91763-4730
Mailing Address - Country:US
Mailing Address - Phone:908-681-2106
Mailing Address - Fax:
Practice Address - Street 1:4651 HOLT BLVD STE H
Practice Address - Street 2:
Practice Address - City:MONTCLAIR
Practice Address - State:CA
Practice Address - Zip Code:91763-4730
Practice Address - Country:US
Practice Address - Phone:909-681-2106
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-22
Last Update Date:2023-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA662824163WG0000X, 163WE0003X, 163W00000X
171400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WE0003XNursing Service ProvidersRegistered NurseEmergency
No163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice
No171400000XOther Service ProvidersHealth & Wellness Coach
No163W00000XNursing Service ProvidersRegistered Nurse