Provider Demographics
NPI:1104055334
Name:SCHNIPKE, DIANA LYNN (MS)
Entity type:Individual
Prefix:
First Name:DIANA
Middle Name:LYNN
Last Name:SCHNIPKE
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:DIANA
Other - Middle Name:LYNN
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS
Mailing Address - Street 1:360 CENTRAL AVE
Mailing Address - Street 2:SUITE 1230
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33701-3857
Mailing Address - Country:US
Mailing Address - Phone:760-904-4656
Mailing Address - Fax:760-203-1194
Practice Address - Street 1:360 CENTRAL AVE
Practice Address - Street 2:SUITE 1230
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33701-3857
Practice Address - Country:US
Practice Address - Phone:760-904-4656
Practice Address - Fax:760-203-1194
Is Sole Proprietor?:No
Enumeration Date:2009-07-09
Last Update Date:2017-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS