Provider Demographics
NPI:1235694266
Name:ELSHIRE, DIANNE (APRN)
Entity Type:Individual
Prefix:
First Name:DIANNE
Middle Name:
Last Name:ELSHIRE
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13523 NW 8TH RD
Mailing Address - Street 2:
Mailing Address - City:NEWBERRY
Mailing Address - State:FL
Mailing Address - Zip Code:32669-3328
Mailing Address - Country:US
Mailing Address - Phone:352-672-1255
Mailing Address - Fax:
Practice Address - Street 1:101 NW 75TH ST STE 3
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32607-6665
Practice Address - Country:US
Practice Address - Phone:352-672-1255
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-04
Last Update Date:2019-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11001087363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily