Provider Demographics
NPI:1396515961
Name:ERNST, DIANA ELIZABETH (RN)
Entity type:Individual
Prefix:
First Name:DIANA
Middle Name:ELIZABETH
Last Name:ERNST
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 1:8633 COPPER KNOLL AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89129-7652
Mailing Address - Country:US
Mailing Address - Phone:219-682-6693
Mailing Address - Fax:
Practice Address - Street 1:4040 S EASTERN AVE
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89119-0810
Practice Address - Country:US
Practice Address - Phone:702-463-0300
Practice Address - Fax:702-463-0301
Is Sole Proprietor?:No
Enumeration Date:2024-01-04
Last Update Date:2024-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV841748163WR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WR0400XNursing Service ProvidersRegistered NurseRehabilitation