Provider Demographics
NPI:1881674596
Name:ALDRICH, DIANNE J DEVOLL (FNP, CNM)
Entity Type:Individual
Prefix:
First Name:DIANNE
Middle Name:J DEVOLL
Last Name:ALDRICH
Suffix:
Gender:F
Credentials:FNP, CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3072 LEJEUNE CIR
Mailing Address - Street 2:
Mailing Address - City:TWENTYNINE PALMS
Mailing Address - State:CA
Mailing Address - Zip Code:92277-9440
Mailing Address - Country:US
Mailing Address - Phone:760-368-9829
Mailing Address - Fax:760-830-2179
Practice Address - Street 1:NAVAL HOSPITAL ATTN PROFESSIONAL AFFAIRS
Practice Address - Street 2:MAGTFTC MCAGCC BOX 788250
Practice Address - City:TWENTYNINE PALMS
Practice Address - State:CA
Practice Address - Zip Code:92278-8250
Practice Address - Country:US
Practice Address - Phone:760-830-2188
Practice Address - Fax:760-830-2179
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIRN23341163W00000X
RIMW00081176B00000X
RINPP22341363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered163W00000XNursing Service ProvidersRegistered Nurse
Not Answered176B00000XOther Service ProvidersMidwife
Not Answered363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily