Diane Allegra Parks, RN, BSN

Key facts

NPI

1104412808

Entity type

Individual (NPI type 1)

Primary specialty

Registered Nurse 163W00000X

License

928752 (TX)

Practice address

35 Apache TRL
Fort Mitchell, AL 36856-5579

Phone

(915) 252-6806

NPI assigned

Dec 16, 2020

Sex

Female

Sole proprietor

No

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

Credentials

Bachelor on Science - Nursing, Registered Nurse

State licenses

Specialties & licenses

Addresses

Other names

• Diane Allegra Hoefner Former name

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Dec 16, 2020.

{
    "created_epoch": "1608076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608076800000",
    "number": "1104412808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35 APACHE TRL",
            "city": "FORT MITCHELL",
            "state": "AL",
            "postal_code": "368565579",
            "telephone_number": "915-252-6806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35 APACHE TRL",
            "city": "FORT MITCHELL",
            "state": "AL",
            "postal_code": "368565579",
            "telephone_number": "915-252-6806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARKS",
        "first_name": "DIANE",
        "middle_name": "ALLEGRA",
        "credential": "RN, BSN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-16",
        "last_updated": "2020-12-16",
        "certification_date": "2020-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TX",
            "license": "928752",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DIANE",
            "last_name": "HOEFNER",
            "middle_name": "ALLEGRA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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All providers in Fort Mitchell, AL · Registered Nurse in Alabama