Active NPI
Diana Wakelyn, LPN
- Licensed Practical Nurse
- Fort Huachuca, AZ
National Provider Identifier
1124550157
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Practical Nurse
- License
- PN5192025
- Practice address
- 2240 Winrow Ave
Fort Huachuca, AZ 85613 - Phone
- (520) 533-9950
- Fax
- (520) 533-6712
- NPI assigned
- Mar 29, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | PN5192025 | FL | Primary |
Addresses
Primary practice location
2240 Winrow Ave
Fort Huachuca, AZ 85613
Mailing address
2927 Player Ave
Sierra Vista, AZ 85650-6601
Phone (321) 848-3713
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PN5192025 | FL | MD | Licensed Practical Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1490745600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1490745600000",
"number": "1124550157",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2927 PLAYER AVE",
"city": "SIERRA VISTA",
"state": "AZ",
"postal_code": "856506601",
"telephone_number": "321-848-3713"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2240 WINROW AVE",
"city": "FORT HUACHUCA",
"state": "AZ",
"postal_code": "85613",
"telephone_number": "520-533-9950",
"fax_number": "520-533-6712"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WAKELYN",
"first_name": "DIANA",
"name_prefix": "Ms.",
"credential": "LPN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-03-29",
"last_updated": "2017-03-29",
"status": "A"
},
"taxonomies": [
{
"code": "164W00000X",
"taxonomy_group": "",
"desc": "Licensed Practical Nurse",
"state": "FL",
"license": "PN5192025",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Huachuca, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.