Provider Demographics
NPI:1689425712
Name:TAYLOR, DIANNA (ARNP)
Entity Type:Individual
Prefix:
First Name:DIANNA
Middle Name:
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:DIANNA
Other - Middle Name:
Other - Last Name:OLAVARRIA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:15508 TIMBERLINE DR
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33624-1618
Mailing Address - Country:US
Mailing Address - Phone:813-464-0925
Mailing Address - Fax:
Practice Address - Street 1:15508 TIMBERLINE DR
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33624-1618
Practice Address - Country:US
Practice Address - Phone:813-464-0925
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-27
Last Update Date:2024-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11031947363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily