Provider Demographics
NPI:1750850160
Name:BISCOBING, DIANE KAY (RN)
Entity Type:Individual
Prefix:
First Name:DIANE
Middle Name:KAY
Last Name:BISCOBING
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:DIANE
Other - Middle Name:KAY
Other - Last Name:HAMBURG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:325 E H ST
Mailing Address - Street 2:
Mailing Address - City:IRON MOUNTAIN
Mailing Address - State:MI
Mailing Address - Zip Code:49801-4760
Mailing Address - Country:US
Mailing Address - Phone:906-774-3300
Mailing Address - Fax:906-779-7454
Practice Address - Street 1:639 W KEMP ST
Practice Address - Street 2:
Practice Address - City:RHINELANDER
Practice Address - State:WI
Practice Address - Zip Code:54501-3879
Practice Address - Country:US
Practice Address - Phone:715-362-4080
Practice Address - Fax:906-779-7454
Is Sole Proprietor?:No
Enumeration Date:2018-11-14
Last Update Date:2018-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704347418163W00000X
WI94545-30163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse