Provider Demographics
NPI:1437426954
Name:LOUD, DIANA (CNP)
Entity Type:Individual
Prefix:
First Name:DIANA
Middle Name:
Last Name:LOUD
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:340 NW 113TH CIR
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34482-8841
Mailing Address - Country:US
Mailing Address - Phone:517-262-0820
Mailing Address - Fax:
Practice Address - Street 1:100 MARION OAKS BLVD
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34473-2209
Practice Address - Country:US
Practice Address - Phone:352-732-6599
Practice Address - Fax:352-694-0885
Is Sole Proprietor?:No
Enumeration Date:2011-11-29
Last Update Date:2021-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9321709363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL008276600Medicaid
FL008276600Medicaid