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NPI Code Detail

MEDICARE: DIANE DEAN APRN

MEDICARE: DIANE DEAN APRN
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 Practitioner53-77056KS

General Provider Information

NPI Number : 1518258029
Entity Type Code : Individual
Provider Name (Legal Business Name) : DIANE DEAN APRN
Provider Business Mailing Address
First Line : 10100 E SHANNON WOODS ST STE 100
Second Line :
City : WICHITA
State : KS
Zip : 67226-4104
Country : US
Telephone Number : 316-219-8299
Fax Number : 316-219-5899
Provider Business Practice Location Address
First Line : 10100 E SHANNON WOODS ST STE 100
Second Line :
City : WICHITA
State : KS
Zip : 67226-4104
Country : US
Telephone Number : 316-219-8299
Fax Number : 162-195-8993
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/02/2011
Last Update Date : 05/04/2020

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Directions to “ DIANE DEAN APRN” Practice Location

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