Provider Demographics
NPI:1659912715
Name:LAFRANCE, DIANA LOUISE (FNP)
Entity Type:Individual
Prefix:
First Name:DIANA
Middle Name:LOUISE
Last Name:LAFRANCE
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 HAWKS RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:ROCKY MOUNT
Mailing Address - State:MO
Mailing Address - Zip Code:65072-3329
Mailing Address - Country:US
Mailing Address - Phone:618-960-8115
Mailing Address - Fax:
Practice Address - Street 1:20 HAWKS RIDGE RD
Practice Address - Street 2:
Practice Address - City:ROCKY MOUNT
Practice Address - State:MO
Practice Address - Zip Code:65072-3329
Practice Address - Country:US
Practice Address - Phone:618-960-8115
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-30
Last Update Date:2019-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2019007055363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily