Healthcare Provider Details

I. General information

NPI: 1225976350
Provider Name (Legal Business Name): KAYLA ROSE DIEKMANN CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/23/2026
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10500 MONTGOMERY RD
MONTGOMERY OH
45242-4402
US

IV. Provider business mailing address

1105 COURTLAND DR
BATAVIA OH
45103-9660
US

V. Phone/Fax

Practice location:
  • Phone: 513-865-1111
  • Fax:
Mailing address:
  • Phone: 513-846-3021
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberAPRN.CRNA.0021579
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: