Provider Demographics
NPI:1225479462
Name:SINKFIELD, DIANNE
Entity Type:Individual
Prefix:MISS
First Name:DIANNE
Middle Name:
Last Name:SINKFIELD
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 1:4108 GRACEWOOD PARK DR
Mailing Address - Street 2:
Mailing Address - City:ELLENWOOD
Mailing Address - State:GA
Mailing Address - Zip Code:30294-2486
Mailing Address - Country:US
Mailing Address - Phone:404-579-7392
Mailing Address - Fax:
Practice Address - Street 1:4108 GRACEWOOD PARK DR
Practice Address - Street 2:
Practice Address - City:ELLENWOOD
Practice Address - State:GA
Practice Address - Zip Code:30294-2486
Practice Address - Country:US
Practice Address - Phone:404-579-7392
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-16
Last Update Date:2013-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPN021626164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse