Provider Demographics
NPI:1194081885
Name:WHITE, DIANE MARIE (RN NP-C)
Entity type:Individual
Prefix:
First Name:DIANE
Middle Name:MARIE
Last Name:WHITE
Suffix:
Gender:F
Credentials:RN NP-C
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Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2807 N GLEBE RD
Mailing Address - Street 2:MARYMOUNT UNIVERSITY STUDENT HEALTH CENTER
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22207-4224
Mailing Address - Country:US
Mailing Address - Phone:703-284-1610
Mailing Address - Fax:703-284-3816
Practice Address - Street 1:2807 N GLEBE RD
Practice Address - Street 2:MARYMOUNT UNIVERSITY STUDENT HEALTH CENTER
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22207-4224
Practice Address - Country:US
Practice Address - Phone:703-284-1610
Practice Address - Fax:703-284-3816
Is Sole Proprietor?:No
Enumeration Date:2012-04-06
Last Update Date:2012-04-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0024114870363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0024114870OtherCOMMONWEALTH OF VIRGINIA LISCENSE TO PRACTICE AS NP
VA0017001008OtherCOMMONWEALTH OF VIRGINIA AUTHORIZATION TO PRESCRIBE LIC NP
VA0001114870OtherCOMMONWEALTH OF VIRGINIA LISCENSE TO PRACTICE AS RN