Provider Demographics
NPI:1194943498
Name:DIACZOK, MAUREEN HELEN (RN)
Entity type:Individual
Prefix:MRS
First Name:MAUREEN
Middle Name:HELEN
Last Name:DIACZOK
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
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Mailing Address - Street 1:122 SHERBURN RD
Mailing Address - Street 2:
Mailing Address - City:SEVERNA PARK
Mailing Address - State:MD
Mailing Address - Zip Code:21146-3045
Mailing Address - Country:US
Mailing Address - Phone:410-647-5172
Mailing Address - Fax:410-222-6840
Practice Address - Street 1:791 AQUAHART RD
Practice Address - Street 2:
Practice Address - City:GLEN BURNIE
Practice Address - State:MD
Practice Address - Zip Code:21061-3961
Practice Address - Country:US
Practice Address - Phone:410-222-6838
Practice Address - Fax:410-222-6840
Is Sole Proprietor?:No
Enumeration Date:2007-04-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDR068521163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health