Diana Mayerly Acevedo Gordillo, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

91797 Issued in PR

Practice address

Kayenta Health Center
High Way 160 MP 394.3
Kayenta, AZ 86033

Phone

(928) 697-4000

NPI assigned

Nov 25, 2020

Last updated

Nov 25, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1606262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606262400000",
    "number": "1851995336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 384",
            "city": "KAYENTA",
            "state": "AZ",
            "postal_code": "860330384",
            "telephone_number": "909-583-4929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "KAYENTA HEALTH CENTER",
            "address_2": "HIGH WAY 160 MP 394.3",
            "city": "KAYENTA",
            "state": "AZ",
            "postal_code": "86033",
            "telephone_number": "928-697-4000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "High way 394",
            "address_purpose": "LOCATION",
            "city": "Kayenta",
            "state": "AZ",
            "postal_code": "860330384",
            "country_code": "US",
            "telephone_number": "909-583-4929",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ACEVEDO GORDILLO",
        "first_name": "DIANA",
        "middle_name": "MAYERLY",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-25",
        "last_updated": "2020-11-25",
        "certification_date": "2020-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "PR",
            "license": "91797",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Christopher Leroy Anderson, PHARMD
• Ronalyn Ivy Alindayu Atienza, RN-BC
• Juliana Austin

• Registered Nurse in Kayenta, AZ
• Providers in Kayenta, AZ by specialty
• Registered Nurse in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2020; 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.