Healthcare Provider Details

I. General information

NPI: 1487786802
Provider Name (Legal Business Name): DIANE CARMEN HITZ RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: DIANE CARMEN KULP RN

II. Dates (important events)

Enumeration Date: 03/12/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CORDELL HULL BUILDING 425 5TH AVE NORTH
NASHVILLE TN
37243-0001
US

IV. Provider business mailing address

1000 OAKHALL DR
MT JULIET TN
37122-6339
US

V. Phone/Fax

Practice location:
  • Phone: 615-741-2703
  • Fax: 615-741-1063
Mailing address:
  • Phone: 615-754-7053
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License Number74946
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: