Provider Demographics
NPI:1588931364
Name:DIEHL, CINDY KAYE (RN)
Entity type:Individual
Prefix:MRS
First Name:CINDY
Middle Name:KAYE
Last Name:DIEHL
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4423 QUWOOD RD
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:45506-3834
Mailing Address - Country:US
Mailing Address - Phone:937-323-5042
Mailing Address - Fax:
Practice Address - Street 1:4423 QUWOOD RD
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:OH
Practice Address - Zip Code:45506-3834
Practice Address - Country:US
Practice Address - Phone:937-323-5042
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-22
Last Update Date:2011-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN253336163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse