Healthcare Provider Details

I. General information

NPI: 1912260183
Provider Name (Legal Business Name): DIANA D COLLINS LPN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: DIANA DENISE COLE LPN

II. Dates (important events)

Enumeration Date: 06/21/2012
Last Update Date: 08/28/2026
Certification Date: 08/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

403 TAYLOR AVE
COLUMBUS OH
43203-1224
US

IV. Provider business mailing address

2630 GLENBRIAR ST
COLUMBUS OH
43232-4670
US

V. Phone/Fax

Practice location:
  • Phone: 614-402-3996
  • Fax:
Mailing address:
  • Phone: 614-972-0498
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License Number149039-M-IV
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: