Diana Connell, RN
Individual provider Active NPI Community Health Registered Nurse · Dulce, NM
NPI 1851550776 · NPPES record last updated Jun 5, 2008
Key facts
- NPI
- 1851550776
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Community Health Registered Nurse 163WC1500X
- License
- 179402 (CO)
- Practice address
- 12000 Stone Lake Road
Dulce, NM 87528-0187 - Phone
- (505) 759-3291
- NPI assigned
- Jun 5, 2008
- 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 |
|---|---|---|---|
| 179402 | CO | MD | Community Health Registered Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Health Registered Nurse | 163WC1500X | 179402 | CO | Yes |
Addresses
Primary practice location
12000 Stone Lake Road
Dulce, NM 87528-0187
Mailing address
PO Box 187
Dulce, NM 87528-0187
Phone (505) 759-3291
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000K3526 | Medicaid | NM | |
| HSZ196 | Other | NM | MEDICARE PART B |
Other providers in Dulce, NM
- Joshua Greer Carney
- Priscilla T Carrillo
- Cecilia E. Chao
- Raquel Irene Cisneros
- Jennifer Lea Lea Claycomb
- Susan Constance
- Samuel Taylor Cropp
- Marie Tallent Deloach
- DHHS/IHS/Aao/Jsu/Dulce Health Center
- Susan Frances Donlon
All providers in Dulce, NM · Community Health Registered Nurse in New Mexico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 5, 2008. 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.