Healthcare Provider Details

I. General information

NPI: 1144388240
Provider Name (Legal Business Name): DIANA L HESS CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DIANA LAKSHMI CARONE

II. Dates (important events)

Enumeration Date: 12/04/2006
Last Update Date: 03/29/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

205 CALUMET CENTER RD
LAGRANGE GA
30241-6711
US

IV. Provider business mailing address

205 CALUMET CENTER RD
LAGRANGE GA
30241-6711
US

V. Phone/Fax

Practice location:
  • Phone: 706-885-1961
  • Fax: 706-885-1963
Mailing address:
  • Phone: 706-885-1961
  • Fax: 706-885-1963

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberRN101860
License Number StateGA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: