Provider Demographics
NPI:1497083612
Name:SCHAEFFER, DIANA KATHLEEN (APRN-CNP)
Entity Type:Individual
Prefix:
First Name:DIANA
Middle Name:KATHLEEN
Last Name:SCHAEFFER
Suffix:
Gender:F
Credentials:APRN-CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5809 NW 103RD PL
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73162-6969
Mailing Address - Country:US
Mailing Address - Phone:405-603-3779
Mailing Address - Fax:
Practice Address - Street 1:5809 NW 103RD PL
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73162-6969
Practice Address - Country:US
Practice Address - Phone:405-603-3779
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-11-29
Last Update Date:2011-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK41846163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice