Provider Demographics
NPI:1366837254
Name:NAVARRO, DIANNE FRANCES (REGISTERED NURSE)
Entity Type:Individual
Prefix:MS
First Name:DIANNE
Middle Name:FRANCES
Last Name:NAVARRO
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 358
Mailing Address - Street 2:
Mailing Address - City:EMPIRE
Mailing Address - State:MI
Mailing Address - Zip Code:49630-0358
Mailing Address - Country:US
Mailing Address - Phone:231-326-2400
Mailing Address - Fax:
Practice Address - Street 1:9620 W FRONT ST
Practice Address - Street 2:
Practice Address - City:EMPIRE
Practice Address - State:MI
Practice Address - Zip Code:49630-9486
Practice Address - Country:US
Practice Address - Phone:231-326-2400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-30
Last Update Date:2015-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI200892163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse