Provider Demographics
NPI:1699476994
Name:HERRON, DIANA
Entity type:Individual
Prefix:
First Name:DIANA
Middle Name:
Last Name:HERRON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5068 STATE ROUTE 222
Mailing Address - Street 2:
Mailing Address - City:BATAVIA
Mailing Address - State:OH
Mailing Address - Zip Code:45103-9783
Mailing Address - Country:US
Mailing Address - Phone:513-708-8983
Mailing Address - Fax:
Practice Address - Street 1:5068 STATE ROUTE 222
Practice Address - Street 2:
Practice Address - City:BATAVIA
Practice Address - State:OH
Practice Address - Zip Code:45103-9783
Practice Address - Country:US
Practice Address - Phone:513-708-8983
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-14
Last Update Date:2023-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant