Provider Demographics
NPI:1154645638
Name:APP, DIANE MARY (RN)
Entity Type:Individual
Prefix:
First Name:DIANE
Middle Name:MARY
Last Name:APP
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 1:5024 N ARDMORE AVE
Mailing Address - Street 2:
Mailing Address - City:WHITEFISH BAY
Mailing Address - State:WI
Mailing Address - Zip Code:53217-5742
Mailing Address - Country:US
Mailing Address - Phone:414-906-5341
Mailing Address - Fax:
Practice Address - Street 1:5024 N ARDMORE AVE
Practice Address - Street 2:
Practice Address - City:WHITEFISH BAY
Practice Address - State:WI
Practice Address - Zip Code:53217-5742
Practice Address - Country:US
Practice Address - Phone:414-906-5341
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-26
Last Update Date:2010-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI164999-30163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse