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NPI Code Detail

MEDICARE: DIANE LYNN THIERY ARNP

MEDICARE:   DIANE LYNN THIERY  ARNP
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
1363LF0000XFamily Nurse Practitioner1256KY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1255335238
Entity Type Code : Individual
Provider Name (Legal Business Name) : DIANE LYNN THIERY ARNP
Provider Business Mailing Address
First Line : 805 BURKESVILLE ST
Second Line :
City : COLUMBIA
State : KY
Zip : 42728-1655
Country : US
Telephone Number : 270-384-1110
Fax Number : 270-384-4241
Provider Business Practice Location Address
First Line : 805 BURKESVILLE ST
Second Line :
City : COLUMBIA
State : KY
Zip : 42728-1655
Country : US
Telephone Number : 270-384-1110
Fax Number : 270-384-4241
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/08/2005
Last Update Date : 07/08/2007

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Directions to “ DIANE LYNN THIERY ARNP” Practice Location

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