Provider Demographics
NPI:1457866006
Name:TRUE, DIAN K (RN, CDE, CLC, FAADE)
Entity Type:Individual
Prefix:MS
First Name:DIAN
Middle Name:K
Last Name:TRUE
Suffix:
Gender:F
Credentials:RN, CDE, CLC, FAADE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:249 COVEY CT
Mailing Address - Street 2:
Mailing Address - City:CODY
Mailing Address - State:WY
Mailing Address - Zip Code:82414-7729
Mailing Address - Country:US
Mailing Address - Phone:307-272-5817
Mailing Address - Fax:
Practice Address - Street 1:904 W SUNSET DR
Practice Address - Street 2:
Practice Address - City:RIVERTON
Practice Address - State:WY
Practice Address - Zip Code:82501-2307
Practice Address - Country:US
Practice Address - Phone:307-272-5817
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-05
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY18500163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Single Specialty