Provider Demographics
NPI:1831577683
Name:DIMOND, NICOLE D (CRNA)
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:D
Last Name:DIMOND
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:NICOLE
Other - Middle Name:D
Other - Last Name:WRIGHT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA
Mailing Address - Street 1:320 E NORTH AVE
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15212-4756
Mailing Address - Country:US
Mailing Address - Phone:412-359-3155
Mailing Address - Fax:412-359-3483
Practice Address - Street 1:1301 CARLISLE ST
Practice Address - Street 2:
Practice Address - City:NATRONA HEIGHTS
Practice Address - State:PA
Practice Address - Zip Code:15065-1152
Practice Address - Country:US
Practice Address - Phone:724-226-7010
Practice Address - Fax:724-226-7404
Is Sole Proprietor?:No
Enumeration Date:2015-05-13
Last Update Date:2022-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN538819367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
PARN538819OtherRN