Provider Demographics
NPI:1134484355
Name:CHOU, DIANA L (FNP)
Entity Type:Individual
Prefix:
First Name:DIANA
Middle Name:L
Last Name:CHOU
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1420 KEY HWY
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21230-5546
Mailing Address - Country:US
Mailing Address - Phone:410-230-7820
Mailing Address - Fax:410-230-7821
Practice Address - Street 1:1420 KEY HWY
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21230
Practice Address - Country:US
Practice Address - Phone:410-230-7820
Practice Address - Fax:410-230-7821
Is Sole Proprietor?:No
Enumeration Date:2012-07-13
Last Update Date:2018-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR208535363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily