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General NPI Number Information
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NPI Number | 1487353470
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Entity Type | Individual
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Provider Name | DIANE LOUISE KRUPKA
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Gender | Female
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Dates
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Enumeration Date | 02/28/2023
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Last Update Date | 02/28/2023
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Provider Practice Location Address
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Address Line | 10701 EAST BLVD
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City | CLEVELAND
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State | OH
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Zip | 44106-1702
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Country | US
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Telephone | 216-791-3800
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Fax | 216-229-2894
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Provider Business Mailing Address
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Address Line | 8843 HENDRICKS RD
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City | MENTOR
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State | OH
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Zip | 44060-2139
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Country | US
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Telephone | 440-346-3190
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Fax | 216-229-2894
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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 | 163WN0300X
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Taxonomy Name | Nephrology Registered Nurse
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License Number | RN.161098
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License Number State | OH
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