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NPI Code Detail

MEDICARE: MS. DIANA BROOKE CZEL ARNP

MEDICARE: MS. DIANA BROOKE CZEL 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
1363LF0000XFamily Nurse Practitioner45699KS
2363LF0000XFamily Nurse Practitioner002105CT
3363LF0000XFamily Nurse Practitioner2426284MN

General Provider Information

NPI Number : 1861483257
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. DIANA BROOKE CZEL ARNP
Provider Business Mailing Address
First Line : 2550 UNIVERSITY AVE W STE 110N
Second Line :
City : SAINT PAUL
State : MN
Zip : 55114-2001
Country : US
Telephone Number : 651-602-5309
Fax Number : 651-222-6786
Provider Business Practice Location Address
First Line : 6545 FRANCE AVE S STE 210
Second Line :
City : EDINA
State : MN
Zip : 55435-2281
Country : US
Telephone Number : 952-928-2900
Fax Number : 952-928-2944
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/03/2005
Last Update Date : 11/29/2017

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