Provider Demographics
NPI:1841510377
Name:SEMMES, DIANE MANNING (FNP)
Entity type:Individual
Prefix:
First Name:DIANE
Middle Name:MANNING
Last Name:SEMMES
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2325 WEYMOUTH DR
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70809-1481
Mailing Address - Country:US
Mailing Address - Phone:225-361-0899
Mailing Address - Fax:
Practice Address - Street 1:2325 WEYMOUTH DR
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70809-1481
Practice Address - Country:US
Practice Address - Phone:225-361-0899
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-07
Last Update Date:2016-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LARN086830363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA2129805Medicaid
MS03250561Medicaid
LA2129805Medicaid
LA3B789CQ60Medicare PIN