Provider Demographics
NPI:1629142252
Name:DIANA, JANICE CHRISTINE (RN)
Entity Type:Individual
Prefix:MS
First Name:JANICE
Middle Name:CHRISTINE
Last Name:DIANA
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 1:1873 DIXIE LN
Mailing Address - Street 2:
Mailing Address - City:ALTOONA
Mailing Address - State:PA
Mailing Address - Zip Code:16602-7615
Mailing Address - Country:US
Mailing Address - Phone:814-942-1101
Mailing Address - Fax:
Practice Address - Street 1:201 CHESTNUT AVE
Practice Address - Street 2:HOME NURSING AGENCY, ADMINISTRATIVE OFFICES
Practice Address - City:ALTOONA
Practice Address - State:PA
Practice Address - Zip Code:16601-4927
Practice Address - Country:US
Practice Address - Phone:814-946-5411
Practice Address - Fax:814-944-2904
Is Sole Proprietor?:No
Enumeration Date:2006-11-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN 192617-L163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse