Healthcare Provider Details

I. General information

NPI: 1558425009
Provider Name (Legal Business Name): DIANE M NOWAKOWSKI ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/20/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1150 45TH ST
WEST PALM BEACH FL
33407-2361
US

IV. Provider business mailing address

1160 SURF RD
SINGER ISLAND FL
33404-3848
US

V. Phone/Fax

Practice location:
  • Phone: 561-514-5300
  • Fax: 561-514-5540
Mailing address:
  • Phone: 561-494-0245
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License NumberARNP3042932
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: