Provider Demographics
NPI:1649345323
Name:MCLAUGHLIN, DIANE THERESE (ARNP)
Entity type:Individual
Prefix:
First Name:DIANE
Middle Name:THERESE
Last Name:MCLAUGHLIN
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 GOODLETTE RD N
Mailing Address - Street 2:SUITE 100
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34102-5474
Mailing Address - Country:US
Mailing Address - Phone:239-649-8384
Mailing Address - Fax:239-643-0094
Practice Address - Street 1:1000 GOODLETTE RD N
Practice Address - Street 2:SUITE 100
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34102-5474
Practice Address - Country:US
Practice Address - Phone:239-649-8384
Practice Address - Fax:239-643-0094
Is Sole Proprietor?:No
Enumeration Date:2006-11-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN1780442363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
P05023Medicare UPIN
E4004ZMedicare ID - Type Unspecified