Diane Kresl, RN
Individual provider Active NPI Registered Nurse · Aztec, NM
NPI 1386192755 · NPPES record last updated Sep 14, 2016
Key facts
- NPI
- 1386192755
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Nurse 163W00000X
- License
- R30362 (NM)
- Practice address
- 500 E Chaco St
Aztec, NM 87410-2170 - Phone
- (505) 334-9414
- Fax
- (505) 599-4387
- NPI assigned
- Sep 14, 2016
- 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
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R30362 | NM | MD | Registered Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | R30362 | NM | Yes |
Addresses
Primary practice location
500 E Chaco St
Aztec, NM 87410-2170
Mailing address
713 Maraboots Cir
Aztec, NM 87410-2080
Phone (505) 334-9414
Other providers in Aztec, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 14, 2016. 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.