Provider Demographics
NPI:1700059938
Name:CRITES, DIANE LYNN (RNFA)
Entity Type:Individual
Prefix:MRS
First Name:DIANE
Middle Name:LYNN
Last Name:CRITES
Suffix:
Gender:F
Credentials:RNFA
Other - Prefix:
Other - First Name:DIANE
Other - Middle Name:LYNN
Other - Last Name:WHITE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:PO BOX 970528
Mailing Address - Street 2:
Mailing Address - City:COCONUT CREEK
Mailing Address - State:FL
Mailing Address - Zip Code:33097-0528
Mailing Address - Country:US
Mailing Address - Phone:954-227-8224
Mailing Address - Fax:954-227-7442
Practice Address - Street 1:361 SE 11TH ST
Practice Address - Street 2:
Practice Address - City:POMPANO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33060-8837
Practice Address - Country:US
Practice Address - Phone:954-227-8224
Practice Address - Fax:954-227-7442
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-09
Last Update Date:2008-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN2582442163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant