Provider Demographics
NPI:1922300276
Name:NORTH, DIANA RONESA
Entity Type:Individual
Prefix:MS
First Name:DIANA
Middle Name:RONESA
Last Name:NORTH
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 1:49 TONYWOOD CIR
Mailing Address - Street 2:
Mailing Address - City:WEST CARROLLTON
Mailing Address - State:OH
Mailing Address - Zip Code:45449-2619
Mailing Address - Country:US
Mailing Address - Phone:937-397-3405
Mailing Address - Fax:
Practice Address - Street 1:49 TONYWOOD CIR
Practice Address - Street 2:
Practice Address - City:WEST CARROLLTON
Practice Address - State:OH
Practice Address - Zip Code:45449-2619
Practice Address - Country:US
Practice Address - Phone:937-397-3405
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-18
Last Update Date:2010-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide