Provider Demographics
NPI:1699901538
Name:DIEM, ALLISON MARIE (CRNP)
Entity type:Individual
Prefix:
First Name:ALLISON
Middle Name:MARIE
Last Name:DIEM
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:ALLISON
Other - Middle Name:MARIE
Other - Last Name:RYE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNP
Mailing Address - Street 1:615 W MACPHAIL RD
Mailing Address - Street 2:
Mailing Address - City:BEL AIR
Mailing Address - State:MD
Mailing Address - Zip Code:21014-4309
Mailing Address - Country:US
Mailing Address - Phone:410-638-8900
Mailing Address - Fax:
Practice Address - Street 1:615 W MACPHAIL RD
Practice Address - Street 2:
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21014-4309
Practice Address - Country:US
Practice Address - Phone:410-638-8900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-05
Last Update Date:2014-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR173526163W00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse