Provider Demographics
NPI:1770628612
Name:BEARSE, DIANNA LEA (DO)
Entity Type:Individual
Prefix:DR
First Name:DIANNA
Middle Name:LEA
Last Name:BEARSE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:1500 ASSOCIATES DR
Mailing Address - Street 2:
Mailing Address - City:DUBUQUE
Mailing Address - State:IA
Mailing Address - Zip Code:52002-2201
Mailing Address - Country:US
Mailing Address - Phone:563-584-4100
Mailing Address - Fax:563-584-4110
Practice Address - Street 1:1240 BIG JACK RD
Practice Address - Street 2:
Practice Address - City:PLATTEVILLE
Practice Address - State:WI
Practice Address - Zip Code:53818-8902
Practice Address - Country:US
Practice Address - Phone:608-348-6266
Practice Address - Fax:608-342-5600
Is Sole Proprietor?:No
Enumeration Date:2007-02-20
Last Update Date:2011-11-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WI56479207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine