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General NPI Number Information
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NPI Number | 1013305200
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Entity Type | Individual
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Provider Name | KRISTINA L DIEHN
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Gender | Female
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Dates
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Enumeration Date | 12/23/2014
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Last Update Date | 02/14/2025
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Provider Practice Location Address
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Address Line | 9969 S 27TH ST FL 2
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City | FRANKLIN
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State | WI
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Zip | 53132-9533
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Country | US
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Telephone | 414-325-4950
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Fax | 414-325-6372
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Provider Business Mailing Address
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Address Line | 5900 S LAKE DR LOWR LEVEL
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City | CUDAHY
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State | WI
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Zip | 53110-3171
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Country | US
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Telephone | 414-744-4000
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Fax | 414-489-4022
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | 6175
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License Number State | WI
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