Provider Demographics
NPI:1114219706
Name:KASHOU, DIANE C (RN)
Entity Type:Individual
Prefix:MS
First Name:DIANE
Middle Name:C
Last Name:KASHOU
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:112 ANNETTA ST
Mailing Address - Street 2:
Mailing Address - City:VESTAL
Mailing Address - State:NY
Mailing Address - Zip Code:13850-2302
Mailing Address - Country:US
Mailing Address - Phone:607-729-0683
Mailing Address - Fax:
Practice Address - Street 1:112 ANNETTA ST
Practice Address - Street 2:
Practice Address - City:VESTAL
Practice Address - State:NY
Practice Address - Zip Code:13850-2302
Practice Address - Country:US
Practice Address - Phone:607-729-0683
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-14
Last Update Date:2011-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY455564-1163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health