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NPI Code Detail

MEDICARE: MRS. DIANE WINN BLAIR FNP-C

MEDICARE: MRS. DIANE WINN BLAIR FNP-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician0024166540VA
2363LF0000XFamily Nurse Practitioner5017325NC
3363LF0000XFamily Nurse Practitioner0024166540VA

General Provider Information

NPI Number : 1114949369
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. DIANE WINN BLAIR FNP-C
Provider Business Mailing Address
First Line : 130 ENTERPRISE DR
Second Line :
City : DANVILLE
State : VA
Zip : 24540-4070
Country : US
Telephone Number : 434-822-1552
Fax Number :
Provider Business Practice Location Address
First Line : 130 ENTERPRISE DR
Second Line :
City : DANVILLE
State : VA
Zip : 24540-4070
Country : US
Telephone Number : 434-791-2273
Fax Number : 434-791-2824
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/24/2006
Last Update Date : 01/09/2023

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Directions to “ MRS. DIANE WINN BLAIR FNP-C” Practice Location

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