Individual provider Active NPI

Diane Resnik, FNP-BC

  • Family Nurse Practitioner
  • Goshen, IN
National Provider Identifier
1548536048
Registry record updated Mar 29, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
28101496A Issued in IN
Practice address
2606 Peddlers Village Rd
Suite 215
Goshen, IN 46526-1004
Phone
(574) 534-1135
NPI assigned
Mar 29, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 28101496A IN Primary

Addresses

Primary practice location

2606 Peddlers Village Rd
Suite 215
Goshen, IN 46526-1004

Mailing address

2606 Peddlers Village Rd
Suite 215
Goshen, IN 46526-1004
Phone (574) 534-1135

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

LicenseStateTypeSpecialty
28101496AINMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1332979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1332979200000",
    "number": "1548536048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2606 PEDDLERS VILLAGE RD",
            "address_2": "SUITE 215",
            "city": "GOSHEN",
            "state": "IN",
            "postal_code": "465261004",
            "telephone_number": "574-534-1135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2606 PEDDLERS VILLAGE RD",
            "address_2": "SUITE 215",
            "city": "GOSHEN",
            "state": "IN",
            "postal_code": "465261004",
            "telephone_number": "574-534-1135"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RESNIK",
        "first_name": "DIANE",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-29",
        "last_updated": "2012-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "28101496A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Goshen, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2012; 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.