Provider Demographics
NPI:1073730610
Name:YELENOSKY, DIANE CAROL (NP-C)
Entity Type:Individual
Prefix:MS
First Name:DIANE
Middle Name:CAROL
Last Name:YELENOSKY
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7140 WALTON RD
Mailing Address - Street 2:
Mailing Address - City:WALTON HILLS
Mailing Address - State:OH
Mailing Address - Zip Code:44146-4359
Mailing Address - Country:US
Mailing Address - Phone:440-668-9207
Mailing Address - Fax:
Practice Address - Street 1:10701 EAST BLVD
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44106-1702
Practice Address - Country:US
Practice Address - Phone:216-791-3800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHNP-09073363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health