Provider Demographics
NPI:1386486785
Name:HARE, DIANE K (RN BSN)
Entity type:Individual
Prefix:
First Name:DIANE
Middle Name:K
Last Name:HARE
Suffix:
Gender:F
Credentials:RN BSN
Other - Prefix:
Other - First Name:DIANE
Other - Middle Name:K
Other - Last Name:DARWISH HARE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN
Mailing Address - Street 1:367 BRYANT AVE
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13204-2603
Mailing Address - Country:US
Mailing Address - Phone:315-450-8297
Mailing Address - Fax:
Practice Address - Street 1:329 N SALINA ST
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13203-1755
Practice Address - Country:US
Practice Address - Phone:315-434-5333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-07
Last Update Date:2024-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY523533163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse