Provider Demographics
NPI:1972875177
Name:MONTAGNA, DIANE (RN,CNOR)
Entity Type:Individual
Prefix:MRS
First Name:DIANE
Middle Name:
Last Name:MONTAGNA
Suffix:
Gender:F
Credentials:RN,CNOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12103 QUAIL CREEK DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77070-2214
Mailing Address - Country:US
Mailing Address - Phone:713-305-3225
Mailing Address - Fax:
Practice Address - Street 1:12103 QUAIL CREEK DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77070-2214
Practice Address - Country:US
Practice Address - Phone:713-305-3225
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-02
Last Update Date:2012-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX541035163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse