Healthcare Provider Details

I. General information

NPI: 1679770986
Provider Name (Legal Business Name): DIANE KAY STAUFFER RN, BSN, WHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/29/2007
Last Update Date: 09/02/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1250 SOUTHWINDS DR
LANTANA FL
33462-1459
US

IV. Provider business mailing address

1250 SOUTHWINDS DR
LANTANA FL
33462-1459
US

V. Phone/Fax

Practice location:
  • Phone: 561-547-6800
  • Fax: 561-837-5332
Mailing address:
  • Phone: 561-547-6800
  • Fax: 561-837-5332

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License NumberARNP1911452
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: