Provider Demographics
NPI:1801909106
Name:WILBERGER, DIANE M (NP)
Entity type:Individual
Prefix:
First Name:DIANE
Middle Name:M
Last Name:WILBERGER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:DIANE
Other - Middle Name:M
Other - Last Name:HOFFMANN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNP
Mailing Address - Street 1:4800 FRIENDSHIP AVE
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15224-1722
Mailing Address - Country:US
Mailing Address - Phone:412-578-6808
Mailing Address - Fax:412-688-7517
Practice Address - Street 1:4800 FRIENDSHIP AVE
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15224-1722
Practice Address - Country:US
Practice Address - Phone:412-578-6808
Practice Address - Fax:412-688-7517
Is Sole Proprietor?:No
Enumeration Date:2006-08-17
Last Update Date:2015-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAVP006724B363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
Q24750Medicare UPIN