MEDICARE: DIANA CARTWRIGHT BSN, RN

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
1	163WH0200X	Home Health Registered Nurse	RN565801	PA

General Provider Information

NPI Number	:	1225777469
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DIANA CARTWRIGHT BSN, RN

Provider Business Mailing Address
First Line	:	374 PHOENIX AVE
Second Line	:
City	:	BELLEFONTE
State	:	PA
Zip	:	16823-1309
Country	:	US
Telephone Number	:	814-810-2389
Fax Number	:	814-810-2390

Provider Business Practice Location Address
First Line	:	374 PHOENIX AVE
Second Line	:
City	:	BELLEFONTE
State	:	PA
Zip	:	16823-1309
Country	:	US
Telephone Number	:	814-810-2389
Fax Number	:	814-810-2390

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/03/2022
Last Update Date	:	06/20/2022

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