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NPI Code Detail

MEDICARE: KIRSTY DIGGER

MEDICARE: KIRSTY DIGGER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse PractitionerF340039-1NY

General Provider Information

NPI Number : 1255701819
Entity Type Code : Individual
Provider Name (Legal Business Name) : KIRSTY DIGGER
Provider Business Mailing Address
First Line : 510 EATONTOWN RD
Second Line :
City : PORT JERVIS
State : NY
Zip : 12771-3604
Country : US
Telephone Number : 845-355-6734
Fax Number :
Provider Business Practice Location Address
First Line : 181 HIGH ST
Second Line :
City : NEWTON
State : NJ
Zip : 07860-1020
Country : US
Telephone Number : 973-383-9898
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/25/2015
Last Update Date : 09/25/2015

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