Provider Demographics
NPI:1891357174
Name:SOUCIER-TAGLIAVINI, DIANNA JAYNE (DNP, FNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:DIANNA
Middle Name:JAYNE
Last Name:SOUCIER-TAGLIAVINI
Suffix:
Gender:F
Credentials:DNP, FNP-BC
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:263 FARMINGTON AVENUE
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06030-2483
Mailing Address - Country:US
Mailing Address - Phone:860-679-4477
Mailing Address - Fax:860-679-0354
Practice Address - Street 1:11 SOUTH ROAD
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:CT
Practice Address - Zip Code:06032-2483
Practice Address - Country:US
Practice Address - Phone:860-679-4477
Practice Address - Fax:860-679-0354
Is Sole Proprietor?:No
Enumeration Date:2019-07-08
Last Update Date:2023-09-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CT8341363LF0000X
CT112132363LS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LS0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerSchool