Provider Demographics
NPI:1750052700
Name:FINTON, DIANA (NPC)
Entity Type:Individual
Prefix:
First Name:DIANA
Middle Name:
Last Name:FINTON
Suffix:
Gender:F
Credentials:NPC
Other - Prefix:
Other - First Name:DIANA
Other - Middle Name:
Other - Last Name:LESLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:3607 COLORADO CT
Mailing Address - Street 2:
Mailing Address - City:FORT WAYNE
Mailing Address - State:IN
Mailing Address - Zip Code:46815-6601
Mailing Address - Country:US
Mailing Address - Phone:260-609-4293
Mailing Address - Fax:
Practice Address - Street 1:885 W CONNEXION WAY
Practice Address - Street 2:
Practice Address - City:COLUMBIA CITY
Practice Address - State:IN
Practice Address - Zip Code:46725-1044
Practice Address - Country:US
Practice Address - Phone:260-564-1946
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-21
Last Update Date:2021-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28184574A163W00000X
IN71011781A363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse