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General NPI Number Information
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NPI Number | 1306368014
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Entity Type | Individual
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Provider Name | DIANA VELASQUEZ CRNP
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Gender | Female
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Dates
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Enumeration Date | 07/13/2017
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Last Update Date | 04/28/2025
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Provider Practice Location Address
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Address Line | 790 NEW HOLLAND AVE STE B
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City | LANCASTER
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State | PA
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Zip | 17602-2137
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Country | US
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Telephone | 717-435-1984
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Fax | 717-674-7688
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Provider Business Mailing Address
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Address Line | PO BOX 746722
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City | ATLANTA
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State | GA
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Zip | 30374-6722
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Country | US
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Telephone | 312-733-9730
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | SP017574
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License Number State | PA
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