Provider Demographics
NPI:1922008135
Name:ENGLAND, DIANNA MAE (PA-C)
Entity Type:Individual
Prefix:
First Name:DIANNA
Middle Name:MAE
Last Name:ENGLAND
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:DIANNA
Other - Middle Name:MAE
Other - Last Name:URBAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:PO BOX 117
Mailing Address - Street 2:
Mailing Address - City:PRESHO
Mailing Address - State:SD
Mailing Address - Zip Code:57568-0117
Mailing Address - Country:US
Mailing Address - Phone:605-895-2415
Mailing Address - Fax:
Practice Address - Street 1:116 N. MAIN ST.
Practice Address - Street 2:
Practice Address - City:PRESHO
Practice Address - State:SD
Practice Address - Zip Code:57568-0422
Practice Address - Country:US
Practice Address - Phone:605-895-2589
Practice Address - Fax:605-895-2325
Is Sole Proprietor?:No
Enumeration Date:2005-07-29
Last Update Date:2013-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD0389363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD8518Medicare ID - Type UnspecifiedMEDICARE PART B