Provider Demographics
NPI:1033129812
Name:GUENDEL, DIANE R (RN,MS,CPND)
Entity Type:Individual
Prefix:MS
First Name:DIANE
Middle Name:R
Last Name:GUENDEL
Suffix:
Gender:F
Credentials:RN,MS,CPND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:919 S CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:SMITHFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23430-1715
Mailing Address - Country:US
Mailing Address - Phone:757-365-8079
Mailing Address - Fax:757-356-9451
Practice Address - Street 1:919 S CHURCH ST
Practice Address - Street 2:
Practice Address - City:SMITHFIELD
Practice Address - State:VA
Practice Address - Zip Code:23430-1715
Practice Address - Country:US
Practice Address - Phone:757-365-8079
Practice Address - Fax:757-356-9451
Is Sole Proprietor?:No
Enumeration Date:2006-08-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024148419207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine