Provider Demographics
NPI:1306368014
Name:VELASQUEZ, DIANA (CRNP)
Entity type:Individual
Prefix:
First Name:DIANA
Middle Name:
Last Name:VELASQUEZ
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:DIANA
Other - Middle Name:
Other - Last Name:SAAVEDRA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 746722
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-6722
Mailing Address - Country:US
Mailing Address - Phone:312-733-9730
Mailing Address - Fax:
Practice Address - Street 1:790 NEW HOLLAND AVE STE B
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17602-2137
Practice Address - Country:US
Practice Address - Phone:717-435-1984
Practice Address - Fax:717-674-7688
Is Sole Proprietor?:No
Enumeration Date:2017-07-13
Last Update Date:2025-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP017574363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily