Provider Demographics
NPI:1235372350
Name:HAKIM, DIANNA X (LPN)
Entity Type:Individual
Prefix:MRS
First Name:DIANNA
Middle Name:X
Last Name:HAKIM
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1387 PLAINFIELD RD
Mailing Address - Street 2:
Mailing Address - City:SOUTH EUCLID
Mailing Address - State:OH
Mailing Address - Zip Code:44121-2511
Mailing Address - Country:US
Mailing Address - Phone:216-382-3986
Mailing Address - Fax:
Practice Address - Street 1:1387 PLAINFIELD RD
Practice Address - Street 2:
Practice Address - City:SOUTH EUCLID
Practice Address - State:OH
Practice Address - Zip Code:44121-2511
Practice Address - Country:US
Practice Address - Phone:216-382-3986
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-20
Last Update Date:2009-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN-096029164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse