Provider Demographics
NPI:1972572105
Name:NELSON-HOUSER, DIANN LYNN (MSN CNP)
Entity Type:Individual
Prefix:MS
First Name:DIANN
Middle Name:LYNN
Last Name:NELSON-HOUSER
Suffix:
Gender:F
Credentials:MSN CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 30780
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43230-0780
Mailing Address - Country:US
Mailing Address - Phone:614-595-3546
Mailing Address - Fax:614-754-5242
Practice Address - Street 1:104 N STYGLER RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43230-2437
Practice Address - Country:US
Practice Address - Phone:614-595-3546
Practice Address - Fax:614-754-5242
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-17
Last Update Date:2013-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHNP07880363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
0007033904OtherAETNA - FOR INPS
510910OtherANTHEM - INPS
OH2499809Medicaid
P00370975OtherRR
0007982742OtherAETNA - DLN-H
319438OtherANTHEM - DLN-H
OHQ21214Medicare UPIN
319438OtherANTHEM - DLN-H
OH2499809Medicaid