MEDICARE: MRS. DIANE NICOLE SHILLING ARNP

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
1	363LF0000X	Family Nurse Practitioner	ARNP9266308	FL

General Provider Information

NPI Number	:	1609236850
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. DIANE NICOLE SHILLING ARNP

Provider Business Mailing Address
First Line	:	249 CENTRAL PARK AVE STE 300
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23462-3271
Country	:	US
Telephone Number	:	877-267-4253
Fax Number	:	877-395-9003

Provider Business Practice Location Address
First Line	:	249 CENTRAL PARK AVE
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23462-3099
Country	:	US
Telephone Number	:	877-267-4253
Fax Number	:	877-395-9003

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/01/2016
Last Update Date	:	11/12/2024

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