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General NPI Number Information
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NPI Number | 1124588603
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Entity Type | Individual
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Provider Name | ANDRIA DIAMOND AGACNP, RN, RNFA
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Gender | Female
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Dates
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Enumeration Date | 03/21/2019
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Last Update Date | 06/03/2022
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Provider Practice Location Address
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Address Line | 3675 J DEWEY GRAY CIR STE 300
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City | AUGUSTA
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State | GA
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Zip | 30909-1868
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Country | US
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Telephone | 706-863-9595
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Fax |
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Provider Business Mailing Address
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Address Line | 3675 J DEWEY GRAY CIR STE 300
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City | AUGUSTA
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State | GA
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Zip | 30909-1868
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Country | US
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Telephone | 706-863-9595
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Fax |
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | APN0000029596
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | GAA-NP000220
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License Number State | GA
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