Provider Demographics
NPI:1740867803
Name:DIEL, PAIGE (DNP)
Entity type:Individual
Prefix:
First Name:PAIGE
Middle Name:
Last Name:DIEL
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:
Other - First Name:PAIGE
Other - Middle Name:
Other - Last Name:WINTERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DNP
Mailing Address - Street 1:8824 SUMMIT ST
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64114-2934
Mailing Address - Country:US
Mailing Address - Phone:913-620-6033
Mailing Address - Fax:
Practice Address - Street 1:8824 SUMMIT ST
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64114-2934
Practice Address - Country:US
Practice Address - Phone:913-620-6033
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-25
Last Update Date:2022-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS13-131914-071163W00000X
KS53-80229-071363L00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner