Provider Demographics
NPI:1215191341
Name:SPRINGER DIAMOND, ELAINE M
Entity Type:Individual
Prefix:
First Name:ELAINE
Middle Name:M
Last Name:SPRINGER DIAMOND
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 268
Mailing Address - Street 2:
Mailing Address - City:STOCKTON
Mailing Address - State:MO
Mailing Address - Zip Code:65785-0268
Mailing Address - Country:US
Mailing Address - Phone:417-276-3930
Mailing Address - Fax:
Practice Address - Street 1:8740 S 1975TH RD
Practice Address - Street 2:
Practice Address - City:HUMANSVILLE
Practice Address - State:MO
Practice Address - Zip Code:65674-8116
Practice Address - Country:US
Practice Address - Phone:417-276-3930
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-17
Last Update Date:2008-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife