Provider Demographics
NPI:1427197045
Name:JANNOTTA, DIANE (CRNFA)
Entity Type:Individual
Prefix:
First Name:DIANE
Middle Name:
Last Name:JANNOTTA
Suffix:
Gender:F
Credentials:CRNFA
Other - Prefix:
Other - First Name:DIANE
Other - Middle Name:
Other - Last Name:ZABINSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNFA
Mailing Address - Street 1:PO BOX 553
Mailing Address - Street 2:
Mailing Address - City:LONGPORT
Mailing Address - State:NJ
Mailing Address - Zip Code:08403-0553
Mailing Address - Country:US
Mailing Address - Phone:609-703-8170
Mailing Address - Fax:
Practice Address - Street 1:115 N 34TH AVE
Practice Address - Street 2:
Practice Address - City:LONGPORT
Practice Address - State:NJ
Practice Address - Zip Code:08403-1622
Practice Address - Country:US
Practice Address - Phone:609-703-8170
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-06
Last Update Date:2016-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NR08790500163WM0705X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical