Provider Demographics
NPI:1407440217
Name:ADAMS, DIANNA LYNN
Entity Type:Individual
Prefix:MS
First Name:DIANNA
Middle Name:LYNN
Last Name:ADAMS
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:DIANNA
Other - Middle Name:LYNN
Other - Last Name:SWILLEY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:APRN, FNP-C
Mailing Address - Street 1:216 BRIARCLIFF DR
Mailing Address - Street 2:
Mailing Address - City:WEST MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71291-9027
Mailing Address - Country:US
Mailing Address - Phone:870-814-0865
Mailing Address - Fax:
Practice Address - Street 1:425 W CAPITOL AVE STE 435
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72201-3642
Practice Address - Country:US
Practice Address - Phone:501-209-8671
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-22
Last Update Date:2023-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LARN158037163W00000X
ARR079442163W00000X
AR216735363LF0000X
LA222078363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse