Provider Demographics
NPI:1740230234
Name:MARCHIANO, DIANNE MARIE (CRNA)
Entity Type:Individual
Prefix:
First Name:DIANNE
Middle Name:MARIE
Last Name:MARCHIANO
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:DIANNE
Other - Middle Name:MARIE
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA
Mailing Address - Street 1:2222 LAGOON DR
Mailing Address - Street 2:
Mailing Address - City:DUNEDIN
Mailing Address - State:FL
Mailing Address - Zip Code:34698-2530
Mailing Address - Country:US
Mailing Address - Phone:727-736-3837
Mailing Address - Fax:
Practice Address - Street 1:10301 GATEWAY BLVD W
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79925-7701
Practice Address - Country:US
Practice Address - Phone:915-595-9000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-12
Last Update Date:2023-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP3141022367500000X
TXAP123722367500000X
VA0024186452367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX328599103Medicaid
FL300821500Medicaid
FLG2158OtherBCBS