Provider Demographics
NPI:1538124318
Name:SAURO, DIANE (CNP)
Entity Type:Individual
Prefix:
First Name:DIANE
Middle Name:
Last Name:SAURO
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:DUMC 3174
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27710-0001
Mailing Address - Country:US
Mailing Address - Phone:919-681-6859
Mailing Address - Fax:919-681-3776
Practice Address - Street 1:DUMC 3174
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27710-0001
Practice Address - Country:US
Practice Address - Phone:919-681-6859
Practice Address - Fax:919-681-9360
Is Sole Proprietor?:No
Enumeration Date:2006-04-18
Last Update Date:2009-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN320732363L00000X
NY304832363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2647336Medicaid
NY2647336Medicaid
NY2647336Medicaid
OH2647336Medicaid
OHSANP78661Medicare PIN
NYSANP78661Medicare PIN