Provider Demographics
NPI:1568689131
Name:DAVIS, DIANNA LYNN (CRNP)
Entity Type:Individual
Prefix:MS
First Name:DIANNA
Middle Name:LYNN
Last Name:DAVIS
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:290 S CENTER ST
Mailing Address - Street 2:POST OFFICE BOX 845
Mailing Address - City:WESTMINSTER
Mailing Address - State:MD
Mailing Address - Zip Code:21157-5219
Mailing Address - Country:US
Mailing Address - Phone:410-876-4925
Mailing Address - Fax:410-876-4959
Practice Address - Street 1:CARROLL COUNTY HEALTH DEPARTMENT
Practice Address - Street 2:290 S. CENTER ST
Practice Address - City:WESTMINSTER
Practice Address - State:MD
Practice Address - Zip Code:21157-5219
Practice Address - Country:US
Practice Address - Phone:410-876-4925
Practice Address - Fax:410-876-4959
Is Sole Proprietor?:No
Enumeration Date:2007-04-18
Last Update Date:2008-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR038763363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily