WANDA JANE DEDEAUX FNP
NPI 1639171234
Nurse Practitioner - Family in Pascagoula, MS

Q: What is Wanda Dedeaux's NPI number?

The NPI number for Wanda Dedeaux is 1639171234. It was assigned to this individual provider in the NPPES registry on August 12, 2005.

Q: What is Wanda Dedeaux's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Q: When was this NPI record last updated?

The NPPES record for Wanda Dedeaux was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since August 12, 2005PECOS Enrolled

1820 OLD MOBILE AVE, PASCAGOULA, MS 39567(228) 696-0230(228) 712-2374 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 30, 2026.

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About Wanda Jane Dedeaux Fnp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

WANDA JANE DEDEAUX FNP (NPI 1639171234) is an individual family provider in Pascagoula, Mississippi, licensed in Mississippi (R744414) and active in the NPI registry since August 2005. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1639171234

Entity TypeIndividualFemale

Primary Taxonomy363LF0000X

Provider Legal NameWANDA JANE DEDEAUXCredential: FNP

Location Address1820 OLD MOBILE AVEPascagoula, MS 39567-4412

Mailing Address4622 Emerson StPascagoula, MS 39581-4713 · (228) 623-5632 · Fax (228) 712-2374

Phone(228) 696-0230

Fax(228) 712-2374

Sole ProprietorNo

Enumeration DateAugust 12, 2005

Last NPPES UpdateJuly 8, 2007

✔ NPI 1639171234 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

License✔ Licensed in MS · R744414

1820 OLD MOBILE AVE, Pascagoula, MS 39567

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Other Identifiers 3

Medicaid00120206MS

Medicare ID-Type Unspecified500000408MS

Medicare UPINS69488MS

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Wanda Jane Dedeaux Fnp is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 39567 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$80.50 typical visit price

range $51.65 – $159.18

Typical copayment $20.12 (range $12.91 – $39.79)

Most-billed visit code 99203

Established Patient

$92.20 typical visit price

range $16.15 – $129.61

Typical copayment $23.05 (range $4.03 – $32.40)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 7

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

GINA COCHRAN LPC

Counselor (Professional)