Provider Demographics
NPI:1376771188
Name:FAUSS, DIANA KAY (APRN, BC, FNP, GNP)
Entity Type:Individual
Prefix:MRS
First Name:DIANA
Middle Name:KAY
Last Name:FAUSS
Suffix:
Gender:F
Credentials:APRN, BC, FNP, GNP
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 843966
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64184-3966
Mailing Address - Country:US
Mailing Address - Phone:573-884-3300
Mailing Address - Fax:573-884-0943
Practice Address - Street 1:1 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65212-0001
Practice Address - Country:US
Practice Address - Phone:573-884-8445
Practice Address - Fax:573-884-7877
Is Sole Proprietor?:No
Enumeration Date:2009-06-30
Last Update Date:2022-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO110168363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOP01408851OtherRAIL ROAD MEDICARE
OK200442630AMedicaid
OK200442630AMedicaid
MO1376771188Medicaid