Provider Demographics
NPI:1720542483
Name:SETTLES, DIANA M (MAT, ATC)
Entity Type:Individual
Prefix:MS
First Name:DIANA
Middle Name:M
Last Name:SETTLES
Suffix:
Gender:F
Credentials:MAT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:193 WHITES NECK LN
Mailing Address - Street 2:
Mailing Address - City:KNOTTS ISLAND
Mailing Address - State:NC
Mailing Address - Zip Code:27950-9636
Mailing Address - Country:US
Mailing Address - Phone:757-818-5749
Mailing Address - Fax:
Practice Address - Street 1:620 JOHN PAUL JONES CIRCLE, SUITE 1100
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:VA
Practice Address - Zip Code:23708-2103
Practice Address - Country:US
Practice Address - Phone:757-953-0956
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-28
Last Update Date:2019-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA174450X2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer