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NPI Code Detail

MEDICARE: DIANE JOHNSTON BRICKER MS.ED, CPRS

MEDICARE: DIANE JOHNSTON BRICKER MS.ED, CPRS
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
1172V00000XCommunity Health WorkerAPS003621OH
2175T00000XPeer Specialist

General Provider Information

NPI Number : 1699507202
Entity Type Code : Individual
Provider Name (Legal Business Name) : DIANE JOHNSTON BRICKER MS.ED, CPRS
Provider Business Mailing Address
First Line : 241 PADDOCK CT STE B
Second Line :
City : DELAWARE
State : OH
Zip : 43015-1317
Country : US
Telephone Number : 740-363-1619
Fax Number :
Provider Business Practice Location Address
First Line : 241 PADDOCK CT STE 3
Second Line :
City : DELAWARE
State : OH
Zip : 43015-1370
Country : US
Telephone Number : 740-363-1619
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/14/2024
Last Update Date : 02/11/2026

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