Healthcare Provider Details

I. General information

NPI: 1598334963
Provider Name (Legal Business Name): JOI DIAMOND CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/21/2021
Last Update Date: 06/21/2021
Certification Date: 06/20/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8000 AL HIGHWAY 69
GUNTERSVILLE AL
35976-7140
US

IV. Provider business mailing address

8000 AL HIGHWAY 69
GUNTERSVILLE AL
35976-7140
US

V. Phone/Fax

Practice location:
  • Phone: 256-571-8000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number2021035920
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: