Provider Demographics
NPI:1376360206
Name:MONTIEL PADALA, DIANNE (RN BSN)
Entity type:Individual
Prefix:
First Name:DIANNE
Middle Name:
Last Name:MONTIEL PADALA
Suffix:
Gender:F
Credentials:RN BSN
Other - Prefix:
Other - First Name:DIANNE
Other - Middle Name:
Other - Last Name:MONTIEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10210 COSMOPOLITAN CIR
Mailing Address - Street 2:
Mailing Address - City:PARKER
Mailing Address - State:CO
Mailing Address - Zip Code:80134-3812
Mailing Address - Country:US
Mailing Address - Phone:765-277-4720
Mailing Address - Fax:
Practice Address - Street 1:14280 E JEWELL AVE STE B
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80012-7939
Practice Address - Country:US
Practice Address - Phone:303-214-3370
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-23
Last Update Date:2024-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1669562163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management