Provider Demographics
NPI:1558108738
Name:STEMMLER-MALLEY, DIANE MARIE (BSN, RN)
Entity type:Individual
Prefix:
First Name:DIANE
Middle Name:MARIE
Last Name:STEMMLER-MALLEY
Suffix:
Gender:F
Credentials:BSN, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5284 BREEZE HILL PL
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48098-2721
Mailing Address - Country:US
Mailing Address - Phone:248-568-5555
Mailing Address - Fax:
Practice Address - Street 1:5284 BREEZE HILL PL
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48098-2721
Practice Address - Country:US
Practice Address - Phone:248-568-5555
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-13
Last Update Date:2024-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704128635163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WC0400XNursing Service ProvidersRegistered NurseCase ManagementGroup - Single Specialty