Provider Demographics
NPI:1346406410
Name:TYRANCE-NEAL, DIANNE (RPH)
Entity Type:Individual
Prefix:MS
First Name:DIANNE
Middle Name:
Last Name:TYRANCE-NEAL
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:DIANNE
Other - Middle Name:
Other - Last Name:TYRANCE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RPH
Mailing Address - Street 1:1838 RANDOLPH ST NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20011-5340
Mailing Address - Country:US
Mailing Address - Phone:202-723-8932
Mailing Address - Fax:
Practice Address - Street 1:50 IRVING ST NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20422-0001
Practice Address - Country:US
Practice Address - Phone:202-745-8000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-29
Last Update Date:2008-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD08045183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist