Provider Demographics
NPI:1427688092
Name:PIASTA, DIANE FRANCES (CNP)
Entity type:Individual
Prefix:MS
First Name:DIANE
Middle Name:FRANCES
Last Name:PIASTA
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 WELLMAN AVENUE
Mailing Address - Street 2:
Mailing Address - City:N. CHELMSFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01863
Mailing Address - Country:US
Mailing Address - Phone:978-251-4050
Mailing Address - Fax:508-251-9050
Practice Address - Street 1:25 WELLMAN AVE
Practice Address - Street 2:
Practice Address - City:N CHELMSFORD
Practice Address - State:MA
Practice Address - Zip Code:01863-1361
Practice Address - Country:US
Practice Address - Phone:978-251-4050
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-22
Last Update Date:2020-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA142050363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics