Provider Demographics
NPI:1528032380
Name:WEST, DIANA N (GNP)
Entity Type:Individual
Prefix:
First Name:DIANA
Middle Name:N
Last Name:WEST
Suffix:
Gender:F
Credentials:GNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 660599
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75266-0599
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1936 AMELIA CT
Practice Address - Street 2:GERIATRICS CENTER & SENIOR SERVICES
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75235-7711
Practice Address - Country:US
Practice Address - Phone:214-590-8369
Practice Address - Fax:214-590-8780
Is Sole Proprietor?:No
Enumeration Date:2006-02-16
Last Update Date:2011-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX255702363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP00279141OtherRAILROAD MEDICARE
TX8N4696OtherBLUE CROSS BLUE SHIELD
TX041532505Medicaid
TX8N4696OtherBLUE CROSS BLUE SHIELD
TXP00279141OtherRAILROAD MEDICARE