Healthcare Provider Details

I. General information

NPI: 1215866223
Provider Name (Legal Business Name): DIANA MARTINGILIO APNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/15/2026
Last Update Date: 05/15/2026
Certification Date: 05/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

831 ARTHUR DR
MILTON WI
53563-3728
US

IV. Provider business mailing address

11101 N SHERMAN RD
EDGERTON WI
53534-9002
US

V. Phone/Fax

Practice location:
  • Phone: 608-868-3526
  • Fax:
Mailing address:
  • Phone: 608-884-3441
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number12345
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: