Fontana, Diane Perine
Fontana, Diane Perine is an individual health care provider with primary practice located at 200 Hawthorne Ln , Charlotte NC 28204-2515. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as her primary health care specialty. Fontana, Diane Perine can be contacted via phone (704) 384-4239.Contact Information
Primary practice address
200 Hawthorne Ln
Charlotte NC 28204-2515
Phone: (704) 384-4239
Fax: (704) 384-5636
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered | 367500000X | 2013006661 | Missouri |
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered | 367500000X | 182054 | North Carolina |
Profile Details
NPI number | 1114926110 |
---|---|
LBN Legal business name | Fontana, Diane Perine |
Credentials | Certified Registered Nurse Anesthetist (CRNA) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Jul 20th, 2005 |
Last updated | May 14th, 2024 - about 7 months 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1114926110 | NPPES |
North Carolina | MEDICAID | 8051588 |
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