Diane Adele Mount Desroches
Individual provider Active NPI Registered Nurse · Durham, CT
NPI 1730458068 · NPPES record last updated Dec 15, 2011
Key facts
- NPI
- 1730458068
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Nurse 163W00000X
- License
- E57219 (CT)
- Practice address
- 459R Wallingford Rd
Durham, CT 06422-1124 - Phone
- (860) 349-1989
- NPI assigned
- Dec 15, 2011
- 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 |
|---|---|---|---|
| E57219 | CT | MD | Registered Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | E57219 | CT | Yes |
Addresses
Primary practice location
459R Wallingford Rd
Durham, CT 06422-1124
Mailing address
459R Wallingford Rd
Durham, CT 06422-1124
Phone (860) 349-1989
Other providers in Durham, CT
- James Burgess
- John M Carbone
- Bianca Carrero
- Christy S. Jackson, PH.D., LLC
- Meghan Kennedy Copeland
- Joseph Donadio
- Walter Joseph Douglass
- Durham Dental LLC
- Durham Dental Studio, PLLC
- Durham Dental, PLLC
All providers in Durham, CT · Registered Nurse in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 15, 2011. 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.