Provider Demographics
NPI:1235388448
Name:DASHNER, DIANNA GAIL (RN)
Entity Type:Individual
Prefix:MRS
First Name:DIANNA
Middle Name:GAIL
Last Name:DASHNER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:DEE
Other - Middle Name:
Other - Last Name:DASHNER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN
Mailing Address - Street 1:1801 SE HILLMOOR DR STE 108
Mailing Address - Street 2:
Mailing Address - City:PORT ST LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34952-7553
Mailing Address - Country:US
Mailing Address - Phone:772-216-3123
Mailing Address - Fax:
Practice Address - Street 1:2500 QUINCY AVE
Practice Address - Street 2:
Practice Address - City:FORT PIERCE
Practice Address - State:FL
Practice Address - Zip Code:34947-4766
Practice Address - Country:US
Practice Address - Phone:772-345-4171
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-11
Last Update Date:2018-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9206767163WA2000X, 163WG0000X
FLARNP9206767363L00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WA2000XNursing Service ProvidersRegistered NurseAdministrator
No163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1235388448OtherINSURANCE