Provider Demographics
NPI:1629753348
Name:SILVA, DIANA LUCIA (CPNP-PC)
Entity Type:Individual
Prefix:MRS
First Name:DIANA
Middle Name:LUCIA
Last Name:SILVA
Suffix:
Gender:F
Credentials:CPNP-PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4837 LOS SERRANOS CT NW
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87120-2807
Mailing Address - Country:US
Mailing Address - Phone:505-554-6395
Mailing Address - Fax:
Practice Address - Street 1:5904 HOLLY AVE NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87113-2472
Practice Address - Country:US
Practice Address - Phone:505-298-2505
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-20
Last Update Date:2023-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM74144363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics