Provider Demographics
NPI:1780844282
Name:BUELL, DIANA EDNA (RN)
Entity Type:Individual
Prefix:MRS
First Name:DIANA
Middle Name:EDNA
Last Name:BUELL
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6803 STATE HIGHWAY 51
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON FLATS
Mailing Address - State:NY
Mailing Address - Zip Code:13315-2027
Mailing Address - Country:US
Mailing Address - Phone:607-965-0015
Mailing Address - Fax:
Practice Address - Street 1:6803 ST HWY 51
Practice Address - Street 2:
Practice Address - City:BURLINGTON FLATS
Practice Address - State:NY
Practice Address - Zip Code:13315-2027
Practice Address - Country:US
Practice Address - Phone:607-965-0015
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-10
Last Update Date:2008-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY427191-1163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health