Provider Demographics
NPI:1619189461
Name:GORBEY, DIANE MARY (RN)
Entity Type:Individual
Prefix:MS
First Name:DIANE
Middle Name:MARY
Last Name:GORBEY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6974 WEATHERBY DR
Mailing Address - Street 2:
Mailing Address - City:MENTOR
Mailing Address - State:OH
Mailing Address - Zip Code:44060-8408
Mailing Address - Country:US
Mailing Address - Phone:216-844-2584
Mailing Address - Fax:216-844-7492
Practice Address - Street 1:11100 EUCLID AVE
Practice Address - Street 2:MPV 5072
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44106-1716
Practice Address - Country:US
Practice Address - Phone:216-844-2584
Practice Address - Fax:216-844-7492
Is Sole Proprietor?:No
Enumeration Date:2007-05-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.207966-COA1364S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364S00000XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse Specialist