Provider Demographics
NPI:1043964646
Name:KIVEN, DIANA YENSI
Entity Type:Individual
Prefix:
First Name:DIANA
Middle Name:YENSI
Last Name:KIVEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13822 CASTLE BLVD APT 201
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20904-7348
Mailing Address - Country:US
Mailing Address - Phone:202-940-3605
Mailing Address - Fax:
Practice Address - Street 1:13822 CASTLE BLVD APT 201
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20904-7348
Practice Address - Country:US
Practice Address - Phone:202-940-3605
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-11
Last Update Date:2022-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDA00193755374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide