Provider Demographics
NPI:1174827992
Name:SELLERS, DIANNE K (LDEM, CPM, CBE,)
Entity Type:Individual
Prefix:MRS
First Name:DIANNE
Middle Name:K
Last Name:SELLERS
Suffix:
Gender:F
Credentials:LDEM, CPM, CBE,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1307 HEAPS RD
Mailing Address - Street 2:
Mailing Address - City:STREET
Mailing Address - State:MD
Mailing Address - Zip Code:21154-1531
Mailing Address - Country:US
Mailing Address - Phone:410-227-6174
Mailing Address - Fax:443-460-1329
Practice Address - Street 1:1307 HEAPS RD
Practice Address - Street 2:
Practice Address - City:STREET
Practice Address - State:MD
Practice Address - Zip Code:21154-1531
Practice Address - Country:US
Practice Address - Phone:410-227-6174
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-08
Last Update Date:2021-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife
No174H00000XOther Service ProvidersHealth Educator