Provider Demographics
NPI:1619056512
Name:MCNERNEY, DIANE M (DNP, ARNP,RNC)
Entity Type:Individual
Prefix:
First Name:DIANE
Middle Name:M
Last Name:MCNERNEY
Suffix:
Gender:F
Credentials:DNP, ARNP,RNC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1858 SPUR LN
Mailing Address - Street 2:
Mailing Address - City:PALM HARBOR
Mailing Address - State:FL
Mailing Address - Zip Code:34685-3324
Mailing Address - Country:US
Mailing Address - Phone:727-784-1344
Mailing Address - Fax:
Practice Address - Street 1:3231 MCMULLEN-BOOTH ROAD
Practice Address - Street 2:
Practice Address - City:SAFETY HARBOR
Practice Address - State:FL
Practice Address - Zip Code:34695
Practice Address - Country:US
Practice Address - Phone:727-725-6753
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-03
Last Update Date:2011-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP 0370622363LC0200X
NYF3501531363LN0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LC0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerCritical Care Medicine
No363LN0005XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal, Critical Care