Provider Demographics
NPI:1083641302
Name:CASS, DIANE LYNNE (MS, RN, ANP)
Entity Type:Individual
Prefix:MS
First Name:DIANE
Middle Name:LYNNE
Last Name:CASS
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Gender:F
Credentials:MS, RN, ANP
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Mailing Address - Street 1:800 IRVING AVENUE
Mailing Address - Street 2:VA MEDICAL CENTER
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13210
Mailing Address - Country:US
Mailing Address - Phone:315-425-4891
Mailing Address - Fax:315-425-2618
Practice Address - Street 1:800 IRVING AVENUE
Practice Address - Street 2:VA MEDICAL CENTER
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13210
Practice Address - Country:US
Practice Address - Phone:315-425-4891
Practice Address - Fax:315-425-2618
Is Sole Proprietor?:No
Enumeration Date:2006-06-26
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
NYF302090363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner