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General NPI Number Information
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NPI Number | 1427669423
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Entity Type | Individual
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Provider Name | DIANNA LOUISE TOMPKINS APRN
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Gender | Female
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Dates
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Enumeration Date | 08/12/2020
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Last Update Date | 02/15/2022
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Provider Practice Location Address
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Address Line | 11820 BEACH BLVD
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City | JACKSONVILLE
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State | FL
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Zip | 32246-6670
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Country | US
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Telephone | 904-642-9100
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Fax |
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Provider Business Mailing Address
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Address Line | 2974 LANTANA LAKES DR E
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City | JACKSONVILLE
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State | FL
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Zip | 32246-1816
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Country | US
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Telephone | 904-631-4016
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 11012464
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 163WP0808X
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Taxonomy Name | Psychiatric/Mental Health Registered Nurse
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License Number | 9430895
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | APRN11012464
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License Number State | FL
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