Provider Demographics
NPI:1568405157
Name:BARBER, DIANE BENSON (FNP-C)
Entity Type:Individual
Prefix:MS
First Name:DIANE
Middle Name:BENSON
Last Name:BARBER
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6966 MILLBRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:CLEMMONS
Mailing Address - State:NC
Mailing Address - Zip Code:27012-9298
Mailing Address - Country:US
Mailing Address - Phone:336-766-7418
Mailing Address - Fax:
Practice Address - Street 1:6966 MILLBRIDGE RD
Practice Address - Street 2:
Practice Address - City:CLEMMONS
Practice Address - State:NC
Practice Address - Zip Code:27012-9298
Practice Address - Country:US
Practice Address - Phone:336-766-7418
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCAPPROVAL #201913363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily