Provider Demographics
NPI:1619203890
Name:FINUCAN, DAINE MARIE (RN)
Entity Type:Individual
Prefix:
First Name:DAINE
Middle Name:MARIE
Last Name:FINUCAN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:DIANE
Other - Middle Name:MARIE
Other - Last Name:ZAPPAVIGNA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:W292N7268 DORN RD
Mailing Address - Street 2:
Mailing Address - City:HARTLAND
Mailing Address - State:WI
Mailing Address - Zip Code:53029-9247
Mailing Address - Country:US
Mailing Address - Phone:262-538-1469
Mailing Address - Fax:
Practice Address - Street 1:W292N7268 DORN RD
Practice Address - Street 2:
Practice Address - City:HARTLAND
Practice Address - State:WI
Practice Address - Zip Code:53029-9247
Practice Address - Country:US
Practice Address - Phone:262-538-1469
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-23
Last Update Date:2010-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI311142-031164W00000X
WI171287-030163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health
No164W00000XNursing Service ProvidersLicensed Practical Nurse