Healthcare Provider Details

I. General information

NPI: 1770380347
Provider Name (Legal Business Name): DIANE LYNN PRASS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/28/2025
Last Update Date: 02/28/2025
Certification Date: 02/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 S CLEVELAND AVE
WESTERVILLE OH
43081-8971
US

IV. Provider business mailing address

2041 ZOLLINGER RD
UPPER ARLINGTON OH
43221-1927
US

V. Phone/Fax

Practice location:
  • Phone: 380-898-4000
  • Fax:
Mailing address:
  • Phone: 614-271-7707
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WM0705X
TaxonomyMedical-Surgical Registered Nurse
License Number263005
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: