Diana Faye Stafford, RPT
Individual provider Active NPI Physical Therapist · Fortville, IN
NPI 1306180369 · NPPES record last updated Nov 15, 2012
Key facts
- NPI
- 1306180369
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 05000680A (IN)
- Practice address
- 8934 W Adell St
Fortville, IN 46040-9200 - Phone
- (317) 485-5266
- NPI assigned
- Nov 15, 2012
- 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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 05000680A | IN | MD | Physical Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 05000680A | IN | Yes |
Addresses
Primary practice location
8934 W Adell St
Fortville, IN 46040-9200
Mailing address
8934 W Adell St
Fortville, IN 46040-9200
Phone (317) 485-5266
Other providers in Fortville, IN
- William Shane Robbins
- Kelly Shores
- Francia Aimee Siler
- Reesa Smith
- Cerissa Sperle
- Bonnie Elaine Sweeney
- Jonathan Taylor
- Travis B. Bunnell, O.D., P.C.
- Beth Turpin
- Matthew Vanhorn
All providers in Fortville, IN · Physical Therapist in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 15, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.