Provider Demographics
NPI:1851017008
Name:BYRD, DIAMOND (APRN-CNP)
Entity Type:Individual
Prefix:
First Name:DIAMOND
Middle Name:
Last Name:BYRD
Suffix:
Gender:F
Credentials:APRN-CNP
Other - Prefix:MS
Other - First Name:DIAMOND
Other - Middle Name:
Other - Last Name:BYRD
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CNP
Mailing Address - Street 1:700 ACKERMAN RD STE 2120
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43202-1559
Mailing Address - Country:US
Mailing Address - Phone:614-685-3333
Mailing Address - Fax:614-293-0077
Practice Address - Street 1:6700 UNIVERSITY BLVD STE 4C
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:OH
Practice Address - Zip Code:43016-3508
Practice Address - Country:US
Practice Address - Phone:614-685-3333
Practice Address - Fax:614-293-0077
Is Sole Proprietor?:No
Enumeration Date:2022-10-18
Last Update Date:2024-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.0031651363L00000X
OHAPRNCNP0031651363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0006477Medicaid