Provider Demographics
NPI:1528487980
Name:DIEP, SANDY (FNP-BC)
Entity type:Individual
Prefix:
First Name:SANDY
Middle Name:
Last Name:DIEP
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:SANDY
Other - Middle Name:
Other - Last Name:DIEP
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:FNP-BC
Mailing Address - Street 1:PO BOX 845347
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75284-7208
Mailing Address - Country:US
Mailing Address - Phone:214-645-2870
Mailing Address - Fax:
Practice Address - Street 1:5939 HARRY HINES BLVD 9TH FL STE 925
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75390-7708
Practice Address - Country:US
Practice Address - Phone:214-645-2870
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-14
Last Update Date:2019-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX771140363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily