MEDICARE: DIANE M. BORCHELT APN

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	163W00000X	Registered Nurse	331806	OH
2	363LA2200X	Adult Health Nurse Practitioner	09469	OH

General Provider Information

NPI Number	:	1710950068
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DIANE M. BORCHELT APN

Provider Business Mailing Address
First Line	:	4360 COOPER RD STE 300
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45242-5636
Country	:	US
Telephone Number	:	513-891-7700
Fax Number	:	513-246-9125

Provider Business Practice Location Address
First Line	:	4360 COOPER RD STE 300
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45242-5636
Country	:	US
Telephone Number	:	513-891-7700
Fax Number	:	513-246-9125

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

Provider Enumeration Date	:	02/08/2006
Last Update Date	:	12/23/2025

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