Provider Demographics
NPI:1992967855
Name:QUIGLEY, DIANE MARIE (LVN)
Entity type:Individual
Prefix:MS
First Name:DIANE
Middle Name:MARIE
Last Name:QUIGLEY
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 W HWY 290
Mailing Address - Street 2:BLDG. A, SUITE 100
Mailing Address - City:DRIPPING SPRINGS
Mailing Address - State:TX
Mailing Address - Zip Code:78620-4191
Mailing Address - Country:US
Mailing Address - Phone:512-858-4100
Mailing Address - Fax:512-858-4223
Practice Address - Street 1:800 W HWY 290
Practice Address - Street 2:BLDG. A, SUITE 100
Practice Address - City:DRIPPING SPRINGS
Practice Address - State:TX
Practice Address - Zip Code:78620-4191
Practice Address - Country:US
Practice Address - Phone:512-858-4100
Practice Address - Fax:512-858-4223
Is Sole Proprietor?:No
Enumeration Date:2008-07-01
Last Update Date:2011-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX120283164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse