Healthcare Provider Details

I. General information

NPI: 1407838816
Provider Name (Legal Business Name): DIANE LYNN NAVARRE CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DIANE LYNN MILLER

II. Dates (important events)

Enumeration Date: 11/19/2005
Last Update Date: 09/25/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

202 LINCOLN HWY W
JEANNETTE PA
15644-3023
US

IV. Provider business mailing address

6637 ROUTE 30
JEANNETTE PA
15644-3023
US

V. Phone/Fax

Practice location:
  • Phone: 724-523-2000
  • Fax:
Mailing address:
  • Phone: 724-523-2000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberTP006414W
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: