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NPI Code Detail

MEDICARE: DIANE PANTELIS CNP

MEDICARE: DIANE PANTELIS CNP
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
1363LA2200XAdult Health Nurse PractitionerNP02840OH
2363LA2200XAdult Health Nurse PractitionerCOA02840NPOH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1871662478
Entity Type Code : Individual
Provider Name (Legal Business Name) : DIANE PANTELIS CNP
Provider Business Mailing Address
First Line : 1001 BELMONT AVE
Second Line :
City : YOUNGSTOWN
State : OH
Zip : 44504-1003
Country : US
Telephone Number : 330-747-6446
Fax Number : 330-746-6843
Provider Business Practice Location Address
First Line : 1001 BELMONT AVE
Second Line :
City : YOUNGSTOWN
State : OH
Zip : 44504-1003
Country : US
Telephone Number : 330-747-6446
Fax Number : 330-746-6843
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/07/2006
Last Update Date : 03/13/2017

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