MEDICARE: DIANA VELASQUEZ RN

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	163W00000X	Registered Nurse	809117	NY
2	163W00000X	Registered Nurse	225860	AK

General Provider Information

NPI Number	:	1871448365
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DIANA VELASQUEZ RN

Provider Business Mailing Address
First Line	:	802 E 10TH AVE APT 7
Second Line	:
City	:	ANCHORAGE
State	:	AK
Zip	:	99501-3873
Country	:	US
Telephone Number	:	907-717-4748
Fax Number	:

Provider Business Practice Location Address
First Line	:	1100 E NORTHERN LIGHTS BLVD
Second Line	:
City	:	ANCHORAGE
State	:	AK
Zip	:	99508-4219
Country	:	US
Telephone Number	:	907-865-5994
Fax Number	:

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

Provider Enumeration Date	:	03/02/2026
Last Update Date	:	03/02/2026

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