Provider Demographics
NPI:1740947829
Name:ADAMS, DIANE LYNNE (RN)
Entity type:Individual
Prefix:
First Name:DIANE
Middle Name:LYNNE
Last Name:ADAMS
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 1:545 SANCTUARY DR APT B606
Mailing Address - Street 2:
Mailing Address - City:LONGBOAT KEY
Mailing Address - State:FL
Mailing Address - Zip Code:34228-3847
Mailing Address - Country:US
Mailing Address - Phone:941-928-9661
Mailing Address - Fax:
Practice Address - Street 1:1540 S TAMIAMI TRL STE 401
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34239-2921
Practice Address - Country:US
Practice Address - Phone:941-917-0060
Practice Address - Fax:941-957-4248
Is Sole Proprietor?:No
Enumeration Date:2021-11-23
Last Update Date:2021-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL2648212163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse