Moore, Diane Marie
Moore, Diane Marie is an individual health care provider with primary practice located at 401 S Ballenger Hwy Attn Surgical Services, Flint MI 48532-3638. 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. Moore, Diane Marie can be contacted via phone (810) 342-4917.Contact Information
Primary practice address
401 S Ballenger Hwy Attn Surgical Services
Flint MI 48532-3638
Phone: (810) 342-4917
Fax: (810) 342-1335
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered | 367500000X | 4704154335 | Michigan |
Profile Details
| NPI number | 1275507816 |
|---|---|
| LBN Legal business name | Moore, Diane Marie |
| Credentials | Certified Registered Nurse Anesthetist (CRNA) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 13th, 2006 |
| Last updated | Dec 11th, 2014 - about 10 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1275507816 | NPPES |
| Michigan | Other | P00002289 | TRAVELER'S |
| Michigan | MEDICAID | 4376308 | TRAVELER'S |
| Michigan | Other | DM154335 | TRAVELER'S |
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