Provider Demographics
NPI:1073815262
Name:KINTNER, DIANE ELAINE (CNP)
Entity Type:Individual
Prefix:
First Name:DIANE
Middle Name:ELAINE
Last Name:KINTNER
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:675 PRICE RD NE
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:OH
Mailing Address - Zip Code:43055-9506
Mailing Address - Country:US
Mailing Address - Phone:740-349-6535
Mailing Address - Fax:740-349-6510
Practice Address - Street 1:675 PRICE RD NE
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:OH
Practice Address - Zip Code:43055-9506
Practice Address - Country:US
Practice Address - Phone:740-349-6535
Practice Address - Fax:740-349-6510
Is Sole Proprietor?:No
Enumeration Date:2010-11-22
Last Update Date:2017-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH09175363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health