Provider Demographics
NPI:1558166967
Name:ALSIDES, DIANA VERONICA
Entity type:Individual
Prefix:
First Name:DIANA
Middle Name:VERONICA
Last Name:ALSIDES
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1415 1ST AVE
Mailing Address - Street 2:
Mailing Address - City:SCOTTSBLUFF
Mailing Address - State:NE
Mailing Address - Zip Code:69361-3104
Mailing Address - Country:US
Mailing Address - Phone:712-406-7148
Mailing Address - Fax:
Practice Address - Street 1:1415 1ST AVE
Practice Address - Street 2:
Practice Address - City:SCOTTSBLUFF
Practice Address - State:NE
Practice Address - Zip Code:69361-3104
Practice Address - Country:US
Practice Address - Phone:712-406-7148
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-18
Last Update Date:2025-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion