Provider Demographics
NPI:1144388240
Name:HESS, DIANA L (CNP)
Entity Type:Individual
Prefix:
First Name:DIANA
Middle Name:L
Last Name:HESS
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:DIANA
Other - Middle Name:LAKSHMI
Other - Last Name:CARONE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:205 CALUMET CENTER RD
Mailing Address - Street 2:
Mailing Address - City:LAGRANGE
Mailing Address - State:GA
Mailing Address - Zip Code:30241-6711
Mailing Address - Country:US
Mailing Address - Phone:706-885-1961
Mailing Address - Fax:706-885-1963
Practice Address - Street 1:205 CALUMET CENTER RD
Practice Address - Street 2:
Practice Address - City:LAGRANGE
Practice Address - State:GA
Practice Address - Zip Code:30241-6711
Practice Address - Country:US
Practice Address - Phone:706-885-1961
Practice Address - Fax:706-885-1963
Is Sole Proprietor?:No
Enumeration Date:2006-12-04
Last Update Date:2011-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN101860208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
Q27359Medicare UPIN
50BBHVVMedicare ID - Type Unspecified