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General NPI Number Information
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NPI Number | 1144399387
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Entity Type | Individual
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Provider Name | DIANE NEDDENRIEP MD
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Gender | Female
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Dates
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Enumeration Date | 11/06/2006
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Last Update Date | 05/02/2013
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Provider Practice Location Address
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Address Line | 5155 E FARNESS DR STE. 111A
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City | TUCSON
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State | AZ
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Zip | 85712-2158
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Country | US
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Telephone | 520-327-1787
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Fax | 520-321-9613
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Provider Business Mailing Address
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Address Line | 5155 E FARNESS DR STE. 111A
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City | TUCSON
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State | AZ
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Zip | 85712-2158
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Country | US
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Telephone | 520-327-1787
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Fax | 520-321-9613
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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 | 2080P0214X
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Taxonomy Name | Pediatric Pulmonology Physician
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License Number | 17428
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License Number State | AZ
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