Provider Demographics
NPI:1053822387
Name:OHMAN, DIANA LYNN (CDE)
Entity Type:Individual
Prefix:MRS
First Name:DIANA
Middle Name:LYNN
Last Name:OHMAN
Suffix:
Gender:F
Credentials:CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:709 WEST EIGHTH STREET
Mailing Address - Street 2:SUITE 4
Mailing Address - City:GILLETTE
Mailing Address - State:WY
Mailing Address - Zip Code:82716
Mailing Address - Country:US
Mailing Address - Phone:307-682-3333
Mailing Address - Fax:307-682-6723
Practice Address - Street 1:709 WEST EIGHTH STREET
Practice Address - Street 2:SUITE 4
Practice Address - City:GILLETTE
Practice Address - State:WY
Practice Address - Zip Code:82716
Practice Address - Country:US
Practice Address - Phone:307-682-3333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-13
Last Update Date:2017-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered