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General NPI Number Information
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NPI Number | 1548297864
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Entity Type | Individual
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Provider Name | CAROLE A DIAMOND MSN, PMHNP-BC, FNP-C
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Gender | Female
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Dates
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Enumeration Date | 06/26/2006
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Last Update Date | 06/18/2019
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Provider Practice Location Address
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Address Line | 1318 S COLLEGE AVE UNIT 2
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City | FORT COLLINS
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State | CO
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Zip | 80524-4175
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Country | US
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Telephone | 970-237-5455
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Fax | 970-815-3775
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Provider Business Mailing Address
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Address Line | 4128 MAIN STREET PO BOX 503
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City | TIMNATH
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State | CO
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Zip | 80547-9997
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Country | US
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Telephone | 623-231-7831
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Fax | 970-815-3775
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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 | 130431 RN; 3548 NP
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 363LX0001X
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Taxonomy Name | Obstetrics & Gynecology Nurse Practitioner
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License Number | 130431 RN; 3548 NP
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License Number State | CO
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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 | RXN.0002013-NP
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License Number State | CO
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