Provider Demographics
NPI:1891361739
Name:HARKER, DIANNE FAYE (NP)
Entity Type:Individual
Prefix:
First Name:DIANNE
Middle Name:FAYE
Last Name:HARKER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:MS
Other - First Name:DIANNE
Other - Middle Name:FAYE
Other - Last Name:HARKER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:NP
Mailing Address - Street 1:700 COOPER AVE
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48602-5383
Mailing Address - Country:US
Mailing Address - Phone:989-583-4000
Mailing Address - Fax:
Practice Address - Street 1:700 COOPER AVE
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48602-5383
Practice Address - Country:US
Practice Address - Phone:989-583-4000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-01
Last Update Date:2021-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704191816363L00000X
MI4704191818NSA210D8163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse