Provider Demographics
NPI:1689399115
Name:HERRERA, DESTINEE DIAMOND (CNA)
Entity Type:Individual
Prefix:MS
First Name:DESTINEE
Middle Name:DIAMOND
Last Name:HERRERA
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2803 ARCHES DR
Mailing Address - Street 2:
Mailing Address - City:PLAINFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60586-2776
Mailing Address - Country:US
Mailing Address - Phone:779-456-1536
Mailing Address - Fax:
Practice Address - Street 1:2803 ARCHES DR
Practice Address - Street 2:
Practice Address - City:PLAINFIELD
Practice Address - State:IL
Practice Address - Zip Code:60586-2776
Practice Address - Country:US
Practice Address - Phone:779-456-1536
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-06
Last Update Date:2022-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care