Provider Demographics
NPI:1417293598
Name:PRICE, DIANA LEE (RN, FNP)
Entity Type:Individual
Prefix:
First Name:DIANA
Middle Name:LEE
Last Name:PRICE
Suffix:
Gender:F
Credentials:RN, FNP
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 2435
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:TX
Mailing Address - Zip Code:76430-8020
Mailing Address - Country:US
Mailing Address - Phone:325-762-2447
Mailing Address - Fax:325-762-2186
Practice Address - Street 1:725 PATE ST
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:TX
Practice Address - Zip Code:76430-3225
Practice Address - Country:US
Practice Address - Phone:325-762-2447
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-12-18
Last Update Date:2021-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX670872363LF0000X
TXAP122920363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX299086YR09Medicare PIN
TX299086YR09Medicare Oscar/Certification