Provider Demographics
NPI:1326472788
Name:DIAMOND, KATLYN THERESA (ARNP)
Entity Type:Individual
Prefix:MRS
First Name:KATLYN
Middle Name:THERESA
Last Name:DIAMOND
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:KATLYN
Other - Middle Name:THERESA
Other - Last Name:BILTHUIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:900 SE SALERNO RD
Mailing Address - Street 2:
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34997-6405
Mailing Address - Country:US
Mailing Address - Phone:772-223-7864
Mailing Address - Fax:
Practice Address - Street 1:900 SE SALERNO RD
Practice Address - Street 2:
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34997-6405
Practice Address - Country:US
Practice Address - Phone:772-223-7864
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-21
Last Update Date:2015-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9308324363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health