Healthcare Provider Details

I. General information

NPI: 1841782265
Provider Name (Legal Business Name): DIANA OLIVERA FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DIANA MONTERO

II. Dates (important events)

Enumeration Date: 06/01/2018
Last Update Date: 03/27/2026
Certification Date: 03/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9610 N METRO PKWY W
PHOENIX AZ
85051-1402
US

IV. Provider business mailing address

3033 N CENTRAL AVE STE 145
PHOENIX AZ
85012-2808
US

V. Phone/Fax

Practice location:
  • Phone: 480-964-2273
  • Fax: 602-843-1560
Mailing address:
  • Phone: 623-583-3001
  • Fax: 623-974-6721

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF07180341
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberAP11597
License Number StateAZ
# 3
Primary TaxonomyN
Taxonomy Code163WP0200X
TaxonomyPediatric Registered Nurse
License Number182604
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: