Provider Demographics
NPI:1992350268
Name:CLEVELAND, DIANE MAY
Entity type:Individual
Prefix:
First Name:DIANE
Middle Name:MAY
Last Name:CLEVELAND
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:DIANE
Other - Middle Name:M
Other - Last Name:INGRAM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:500 N RAINBOW BLVD STE 300 IDEAL STAFFING INC
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89107
Mailing Address - Country:US
Mailing Address - Phone:702-305-5377
Mailing Address - Fax:855-710-6639
Practice Address - Street 1:500 N RAINBOW BLVD STE 300 IDEAL STAFFING INC
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89107
Practice Address - Country:US
Practice Address - Phone:702-305-5377
Practice Address - Fax:855-710-6639
Is Sole Proprietor?:No
Enumeration Date:2019-08-05
Last Update Date:2019-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant