Provider Demographics
NPI:1013241702
Name:ZACHARIAS, DIANNE ARLENE (LPN)
Entity Type:Individual
Prefix:
First Name:DIANNE
Middle Name:ARLENE
Last Name:ZACHARIAS
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:DIANNE
Other - Middle Name:ARLENE
Other - Last Name:SHUGRUE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPN
Mailing Address - Street 1:10065 E HARVARD AVE
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80231-5968
Mailing Address - Country:US
Mailing Address - Phone:303-579-8264
Mailing Address - Fax:
Practice Address - Street 1:10065 E HARVARD AVE
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80231-5968
Practice Address - Country:US
Practice Address - Phone:303-579-8264
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-28
Last Update Date:2009-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO15266164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse