Provider Demographics
NPI:1588661987
Name:LOYNES, DIANA MARIE (NURSE PRACTITIONER)
Entity type:Individual
Prefix:
First Name:DIANA
Middle Name:MARIE
Last Name:LOYNES
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8210 KEWEENAW ST
Mailing Address - Street 2:
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49009-5957
Mailing Address - Country:US
Mailing Address - Phone:269-372-6038
Mailing Address - Fax:269-639-8888
Practice Address - Street 1:8210 KEWEENAW ST
Practice Address - Street 2:
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49009-5957
Practice Address - Country:US
Practice Address - Phone:269-372-6038
Practice Address - Fax:269-639-8888
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-30
Last Update Date:2008-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704142535363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily