Provider Demographics
NPI:1871194712
Name:STRAIT, DIANE SUE
Entity Type:Individual
Prefix:MRS
First Name:DIANE
Middle Name:SUE
Last Name:STRAIT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 NORTH ST
Mailing Address - Street 2:
Mailing Address - City:SUNBURY
Mailing Address - State:OH
Mailing Address - Zip Code:43074-9304
Mailing Address - Country:US
Mailing Address - Phone:740-972-2009
Mailing Address - Fax:
Practice Address - Street 1:125 NORTH ST
Practice Address - Street 2:
Practice Address - City:SUNBURY
Practice Address - State:OH
Practice Address - Zip Code:43074-9304
Practice Address - Country:US
Practice Address - Phone:740-972-2009
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-06
Last Update Date:2020-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide