Provider Demographics
NPI:1629390778
Name:LABBAN, DIANE (FNP)
Entity Type:Individual
Prefix:MRS
First Name:DIANE
Middle Name:
Last Name:LABBAN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:MRS
Other - First Name:DIANE
Other - Middle Name:
Other - Last Name:LABAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:FNP
Mailing Address - Street 1:4545 E CHANDLER BLVD STE 308
Mailing Address - Street 2:#308
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85048-7646
Mailing Address - Country:US
Mailing Address - Phone:480-893-2100
Mailing Address - Fax:
Practice Address - Street 1:4545 E CHANDLER BLVD STE 308
Practice Address - Street 2:#308
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85048-7646
Practice Address - Country:US
Practice Address - Phone:480-893-2100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-02-17
Last Update Date:2010-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP3516363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily