Provider Demographics
NPI:1508022534
Name:GREVE, DIANA (FNP-BC)
Entity Type:Individual
Prefix:
First Name:DIANA
Middle Name:
Last Name:GREVE
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3434 HANCOCK BRIDGE PKWY
Mailing Address - Street 2:STE. 301
Mailing Address - City:NORTH FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33903-7094
Mailing Address - Country:US
Mailing Address - Phone:219-261-3411
Mailing Address - Fax:
Practice Address - Street 1:1735 SW HEALTH PKWY
Practice Address - Street 2:STE 201
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34109-0421
Practice Address - Country:US
Practice Address - Phone:219-261-3411
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-30
Last Update Date:2014-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71000230A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily