Provider Demographics
NPI:1730495615
Name:STARKEY, DIANE LYNN (LPN)
Entity Type:Individual
Prefix:
First Name:DIANE
Middle Name:LYNN
Last Name:STARKEY
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6915 COUNTY ROAD 15
Mailing Address - Street 2:
Mailing Address - City:CENTERBURG
Mailing Address - State:OH
Mailing Address - Zip Code:43011-9623
Mailing Address - Country:US
Mailing Address - Phone:740-507-7419
Mailing Address - Fax:740-625-6718
Practice Address - Street 1:6915 COUNTY ROAD 15
Practice Address - Street 2:
Practice Address - City:CENTERBURG
Practice Address - State:OH
Practice Address - Zip Code:43011-9623
Practice Address - Country:US
Practice Address - Phone:740-507-7419
Practice Address - Fax:740-625-6718
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-30
Last Update Date:2010-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN099748164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse