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NPI Code Detail

MEDICARE: DIANA SULEYMANOVA MSN-PH, APRN, FNP-C

MEDICARE: DIANA SULEYMANOVA MSN-PH, APRN, 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
1363LF0000XFamily Nurse Practitioner303160AZ

General Provider Information

NPI Number : 1609624154
Entity Type Code : Individual
Provider Name (Legal Business Name) : DIANA SULEYMANOVA MSN-PH, APRN, FNP-C
Provider Business Mailing Address
First Line : 1100 E BELL RD APT 1027
Second Line :
City : PHOENIX
State : AZ
Zip : 85022-3172
Country : US
Telephone Number : 602-722-8770
Fax Number :
Provider Business Practice Location Address
First Line : 8825 N 23RD AVE
Second Line :
City : PHOENIX
State : AZ
Zip : 85021-4147
Country : US
Telephone Number : 888-256-3814
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/09/2024
Last Update Date : 05/13/2024

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