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General NPI Number Information
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NPI Number | 1023872751
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Entity Type | Individual
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Provider Name | DIAMOND NOWELL
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Gender | Female
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Dates
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Enumeration Date | 02/13/2024
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Last Update Date | 03/18/2025
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Provider Practice Location Address
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Address Line | 128 E BROAD ST
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City | SAINT PAULS
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State | NC
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Zip | 28384-1610
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Country | US
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Telephone | 910-241-3042
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Fax | 910-241-3462
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Provider Business Mailing Address
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Address Line | 60 COMMERCE PLAZA CIR
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City | PEMBROKE
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State | NC
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Zip | 28372-7386
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Country | US
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Telephone | 910-521-2900
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Fax | 910-775-9165
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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 | 5021246
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License Number State | NC
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