Provider Demographics
NPI:1558515783
Name:WOMACK, DIANE MARIE (APRN, FNP-C)
Entity type:Individual
Prefix:
First Name:DIANE
Middle Name:MARIE
Last Name:WOMACK
Suffix:
Gender:F
Credentials:APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4510 MEDICAL CENTER DR STE 206
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75069-1605
Mailing Address - Country:US
Mailing Address - Phone:469-631-0022
Mailing Address - Fax:469-796-5036
Practice Address - Street 1:4510 MEDICAL CENTER DR STE 206
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75069-1605
Practice Address - Country:US
Practice Address - Phone:469-631-0022
Practice Address - Fax:469-796-5036
Is Sole Proprietor?:No
Enumeration Date:2008-11-14
Last Update Date:2024-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP111282363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily