Bryan, Diane J

Bryan, Diane J is an individual health care provider with primary practice located at 635 E. Baseline Rd. , Phoenix AZ 85042-6551. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Pediatrics, which is considered as her primary health care specialty. Bryan, Diane J can be contacted via phone (602) 243-7277.

Contact Information

Primary practice address
635 E. Baseline Rd. Phoenix AZ 85042-6551
Phone: (602) 243-7277
Fax: (602) 243-1235
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Pediatrics 363LP0200X RN033350 Arizona
Physician Assistants & Advanced Practice Nursing Providers / Pediatrics 363LP0200X AP0100 Arizona

Profile Details

NPI number 1093843070
LBN Legal business name Bryan, Diane J
Credentials Pediatric Nurse Practitioner (PNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 1st, 2007
Last updated Jan 22nd, 2010 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1093843070 NPPES
Arizona MEDICAID 173295

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