Healthcare Provider Details

I. General information

NPI: 1952494171
Provider Name (Legal Business Name): ELIZABETH DIAMOND ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/02/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1285 CREEKSIDE BLVD E UNIT 102
NAPLES FL
34109-0595
US

IV. Provider business mailing address

1285 CREEKSIDE BLVD E UNIT 102
NAPLES FL
34109-0595
US

V. Phone/Fax

Practice location:
  • Phone: 239-624-8070
  • Fax: 239-624-8071
Mailing address:
  • Phone: 239-624-8070
  • Fax: 239-624-8071

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberARNP 1676812
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: