Provider Demographics
NPI:1568835973
Name:SPRINKLE, DIANA (NP-C)
Entity Type:Individual
Prefix:
First Name:DIANA
Middle Name:
Last Name:SPRINKLE
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:615 7TH AVE
Mailing Address - Street 2:PO BOX 1177
Mailing Address - City:BOWLING GREEN
Mailing Address - State:KY
Mailing Address - Zip Code:42101-6921
Mailing Address - Country:US
Mailing Address - Phone:270-783-3573
Mailing Address - Fax:270-783-4081
Practice Address - Street 1:615 7TH AVE
Practice Address - Street 2:
Practice Address - City:BOWLING GREEN
Practice Address - State:KY
Practice Address - Zip Code:42101-6921
Practice Address - Country:US
Practice Address - Phone:270-783-3573
Practice Address - Fax:270-783-4081
Is Sole Proprietor?:No
Enumeration Date:2015-11-06
Last Update Date:2015-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3009877363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY3009877OtherAPRN LICENSE