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General NPI Number Information
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NPI Number | 1881778991
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Entity Type | Individual
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Provider Name | DIANNA H. LEASE APN
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Gender | Female
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Dates
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Enumeration Date | 10/25/2006
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Last Update Date | 09/29/2011
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Provider Practice Location Address
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Address Line | ATLANTICARE REGIONAL MEDICAL CENTER JIMMIE LEEDS RD.
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City | POMONA
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State | NJ
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Zip | 08240-9104
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Country | US
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Telephone | 609-652-3599
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Fax | 609-652-3495
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Provider Business Mailing Address
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Address Line | PO BOX 191 PROVIDER ENROLLMENT DEPT
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City | ROCKLAND
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State | DE
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Zip | 19732-0191
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Country | US
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Telephone | 302-651-6212
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Fax | 302-651-4945
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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 | NR08041700
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 363LN0000X
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Taxonomy Name | Neonatal Nurse Practitioner
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License Number | NR08041700
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License Number State | NJ
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Taxonomy #3
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Taxonomy Code | 363LN0005X
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Taxonomy Name | Critical Care Neonatal Nurse Practitioner
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License Number | NR08041700
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License Number State | NJ
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Taxonomy #4
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Taxonomy Code | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | NR08041700
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License Number State | NJ
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