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General NPI Number Information
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NPI Number | 1740896059
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Entity Type | Individual
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Provider Name | CHARLENE RH DIMOND FNP-C
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Gender | Female
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Dates
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Enumeration Date | 09/22/2020
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Last Update Date | 10/23/2025
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Provider Practice Location Address
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Address Line | 89 INTERCHANGE DR
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City | RICHMOND HILL
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State | GA
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Zip | 31324-7664
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Country | US
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Telephone | 912-527-5253
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Fax |
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Provider Business Mailing Address
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Address Line | 33 NOBLE GLEN DR
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City | SAVANNAH
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State | GA
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Zip | 31406-7544
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Country | US
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Telephone | 912-656-1806
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | APRN-NP156866
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License Number State | GA
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