Healthcare Provider Details

I. General information

NPI: 1083248991
Provider Name (Legal Business Name): DIANA P LEVY MSN, MBA, CRNA, APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/29/2020
Last Update Date: 09/18/2020
Certification Date: 09/16/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CARLSBAD MEDICAL CENTER 2430 W PIERCE ST.
CARLSBAD NM
88220
US

IV. Provider business mailing address

CARSLBAD MEDICAL CENTER 2430 W PIERCE ST.
CARLSBAD NM
88220
US

V. Phone/Fax

Practice location:
  • Phone: 575-887-4100
  • Fax: 575-887-4531
Mailing address:
  • Phone: 575-887-4100
  • Fax: 575-887-4531

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberC-APN.0002126-C-CRNA
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberAPRN11007353
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number61201
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: