Provider Demographics
NPI:1285185546
Name:SAWYER, DIANE KAYE (APRN)
Entity Type:Individual
Prefix:MRS
First Name:DIANE
Middle Name:KAYE
Last Name:SAWYER
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 1:4000 FAIRFIELD GARDENS COURT
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40245
Mailing Address - Country:US
Mailing Address - Phone:502-243-1169
Mailing Address - Fax:
Practice Address - Street 1:3903 VANTAGE PL
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40299-6801
Practice Address - Country:US
Practice Address - Phone:502-356-4377
Practice Address - Fax:888-959-2460
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-20
Last Update Date:2017-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3010663363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily