Provider Demographics
NPI:1134893100
Name:STETLER, DIANA (RN)
Entity type:Individual
Prefix:
First Name:DIANA
Middle Name:
Last Name:STETLER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2402 SOUTH ST
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:IN
Mailing Address - Zip Code:47904-3063
Mailing Address - Country:US
Mailing Address - Phone:765-446-9229
Mailing Address - Fax:765-446-9339
Practice Address - Street 1:2402 SOUTH ST
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:IN
Practice Address - Zip Code:47904-3063
Practice Address - Country:US
Practice Address - Phone:765-446-9229
Practice Address - Fax:765-446-9339
Is Sole Proprietor?:No
Enumeration Date:2021-08-04
Last Update Date:2021-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28126022A364SL0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SL0600XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistLong-Term Care