Provider Demographics
NPI:1265212237
Name:PUENTE HEAD, DIANA NOEMI (DNP, AGACNP-BC, APRN)
Entity type:Individual
Prefix:
First Name:DIANA
Middle Name:NOEMI
Last Name:PUENTE HEAD
Suffix:
Gender:
Credentials:DNP, AGACNP-BC, APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14300 W GRANITE VALLEY DR STE E23
Mailing Address - Street 2:
Mailing Address - City:SUN CITY
Mailing Address - State:AZ
Mailing Address - Zip Code:85375-5798
Mailing Address - Country:US
Mailing Address - Phone:623-975-0500
Mailing Address - Fax:
Practice Address - Street 1:14300 W GRANITE VALLEY DR STE E23
Practice Address - Street 2:
Practice Address - City:SUN CITY
Practice Address - State:AZ
Practice Address - Zip Code:85375-5798
Practice Address - Country:US
Practice Address - Phone:623-975-0500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-05
Last Update Date:2025-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ196201163WC0200X
AZ320651363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine