Hackett, Diana Lynn

Hackett, Diana Lynn is an individual health care provider with primary practice located at 2157 Green Valley Rd , Bridgeport WV 26330. 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. Hackett, Diana Lynn can be contacted via phone (304) 699-4103.

Contact Information

Primary practice address
2157 Green Valley Rd Bridgeport WV 26330
Phone: (304) 699-4103
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 39055 West Virginia

Profile Details

NPI number 1114078847
LBN Legal business name Hackett, Diana Lynn
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 16th, 2007
Last updated May 14th, 2018 - about 7 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 1114078847 NPPES
West Virginia MEDICAID 0067524000
West Virginia Other 0207026000
West Virginia Other 9333201

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