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General NPI Number Information
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NPI Number | 1497421150
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Entity Type | Individual
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Provider Name | DIANA LYNN LIGTENBERG APRN
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Gender | Female
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Dates
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Enumeration Date | 08/20/2021
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Last Update Date | 08/20/2021
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Provider Practice Location Address
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Address Line | 5850 E MILTON RD
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City | MILTON
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State | FL
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Zip | 32583-7914
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Country | US
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Telephone | 251-229-1095
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Fax |
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Provider Business Mailing Address
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Address Line | 2550 OCALA DR
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City | FOLEY
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State | AL
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Zip | 36535-7480
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Country | US
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Telephone | 251-229-1095
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | APRN11013184
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License Number State | FL
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