Provider Demographics
NPI:1063814226
Name:ANTHONY, DIANE
Entity Type:Individual
Prefix:
First Name:DIANE
Middle Name:
Last Name:ANTHONY
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 1:2 YORKTOWN RD
Mailing Address - Street 2:
Mailing Address - City:NEW CASTLE
Mailing Address - State:DE
Mailing Address - Zip Code:19720-4222
Mailing Address - Country:US
Mailing Address - Phone:484-602-1273
Mailing Address - Fax:302-322-6230
Practice Address - Street 1:2 YORKTOWN RD
Practice Address - Street 2:
Practice Address - City:NEW CASTLE
Practice Address - State:DE
Practice Address - Zip Code:19720-4222
Practice Address - Country:US
Practice Address - Phone:484-602-1273
Practice Address - Fax:302-322-6230
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-18
Last Update Date:2014-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEL1-0045111163W00000X
PARN607795163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health
No163W00000XNursing Service ProvidersRegistered Nurse