Provider Demographics
NPI:1700857455
Name:YAUNCHES, DIANE MARY (CNM)
Entity Type:Individual
Prefix:
First Name:DIANE
Middle Name:MARY
Last Name:YAUNCHES
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1635 N GEORGE MASON DRIVE
Mailing Address - Street 2:SUITE 185
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22205
Mailing Address - Country:US
Mailing Address - Phone:703-516-9600
Mailing Address - Fax:703-516-9053
Practice Address - Street 1:1635 N GEORGE MASON DRIVE
Practice Address - Street 2:SUITE 185
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22205
Practice Address - Country:US
Practice Address - Phone:703-516-9600
Practice Address - Fax:703-516-9053
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024164307176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA005486G01Medicare ID - Type Unspecified
S64778Medicare UPIN