Provider Demographics
NPI:1700883105
Name:FOX, DIANE CATHERINE (CRNP)
Entity type:Individual
Prefix:MRS
First Name:DIANE
Middle Name:CATHERINE
Last Name:FOX
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1382 NEWTOWN LANGHORNE RD
Mailing Address - Street 2:
Mailing Address - City:NEWTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18940-2401
Mailing Address - Country:US
Mailing Address - Phone:215-504-6809
Mailing Address - Fax:215-579-0266
Practice Address - Street 1:1382 NEWTOWN LANGHORNE RD
Practice Address - Street 2:
Practice Address - City:NEWTOWN
Practice Address - State:PA
Practice Address - Zip Code:18940-2401
Practice Address - Country:US
Practice Address - Phone:215-504-6809
Practice Address - Fax:215-579-0266
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-30
Last Update Date:2024-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP003791C363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
S47235Medicare UPIN