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NPI Code Detail

MEDICARE: DIANNE JOYCE HOEKSTRA RN, CNS, APRN, BC

MEDICARE: DIANNE JOYCE HOEKSTRA RN, CNS, APRN, BC
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
1364SA2200XAdult Health Clinical Nurse Specialist70000134AIN

General Provider Information

NPI Number : 1609964758
Entity Type Code : Individual
Provider Name (Legal Business Name) : DIANNE JOYCE HOEKSTRA RN, CNS, APRN, BC
Provider Business Mailing Address
First Line : 3243 202ND ST
Second Line :
City : LYNWOOD
State : IL
Zip : 60411-8708
Country : US
Telephone Number : 708-474-7745
Fax Number :
Provider Business Practice Location Address
First Line : 9660 WICKER AVE
Second Line :
City : SAINT JOHN
State : IN
Zip : 46373-9487
Country : US
Telephone Number : 219-365-1166
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/11/2006
Last Update Date : 07/09/2007

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