Individual provider Active NPI

Diana Lynne Kesler-la Clair, RN FNP

  • Nurse Practitioner
  • Mesa, AZ
National Provider Identifier
1053313643
Registry record updated Nov 29, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN 051167 Issued in AZ
Practice address
130 S 63Rd St
BLDG 3 Suite 114
Mesa, AZ 85206-1620
Phone
(480) 981-2888
Fax
(480) 654-0599
NPI assigned
Aug 12, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X RN 051167 AZ Primary

Addresses

Primary practice location

130 S 63Rd St
BLDG 3 Suite 114
Mesa, AZ 85206-1620

Mailing address

130 S 63Rd St
BLDG 3 Suite 114
Mesa, AZ 85206-1620
Phone (480) 981-2888

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN 051167AZMDNurse Practitioner

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1123804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196294400000",
    "number": "1053313643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 S 63RD ST",
            "address_2": "BLDG 3 SUITE 114",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852061620",
            "telephone_number": "480-981-2888",
            "fax_number": "480-654-0599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 S 63RD ST",
            "address_2": "BLDG 3 SUITE 114",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852061620",
            "telephone_number": "480-981-2888",
            "fax_number": "480-654-0599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KESLER-LA CLAIR",
        "first_name": "DIANA",
        "middle_name": "LYNNE",
        "credential": "RN FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-12",
        "last_updated": "2007-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AZ",
            "license": "RN 051167",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.