Provider Demographics
NPI:1003132812
Name:DIABATE, MAGNINI KRISTY (CNA/GNA #A0009022)
Entity Type:Individual
Prefix:
First Name:MAGNINI
Middle Name:KRISTY
Last Name:DIABATE
Suffix:
Gender:F
Credentials:CNA/GNA #A0009022
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13178 LARCHDALE RD
Mailing Address - Street 2:#7
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20708-1765
Mailing Address - Country:US
Mailing Address - Phone:240-427-6672
Mailing Address - Fax:240-565-0556
Practice Address - Street 1:13178 LARCHDALE RD
Practice Address - Street 2:#7
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20708-1765
Practice Address - Country:US
Practice Address - Phone:240-427-6672
Practice Address - Fax:240-565-0556
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-19
Last Update Date:2010-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health