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General NPI Number Information
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NPI Number | 1245419548
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Entity Type | Individual
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Provider Name | DIANE ELAINE KNUDSEN DHA, CRNP
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Gender | Female
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Dates
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Enumeration Date | 11/02/2007
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Last Update Date | 03/12/2025
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Provider Practice Location Address
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Address Line | 549 FAIR ST
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City | BLOOMSBURG
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State | PA
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Zip | 17815-1419
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Country | US
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Telephone | 570-387-2111
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Fax | 570-387-2245
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Provider Business Mailing Address
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Address Line | 100 N ACADEMY AVE # 4903
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City | DANVILLE
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State | PA
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Zip | 17822-9800
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Country | US
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Telephone | 570-271-6144
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Fax | 570-271-6578
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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 | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | SP009385
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 26NJ00303600
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License Number State | NJ
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Taxonomy #3
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | F301792
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License Number State | NY
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Taxonomy #4
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | SP012241
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License Number State | PA
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Taxonomy #5
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | SP012241
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License Number State | PA
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