Diana Mayerly Acevedo Gordillo, RN
Individual provider Active NPI Registered Nurse · Kayenta, AZ
NPI 1851995336 · NPPES record last updated Nov 25, 2020
Key facts
- NPI
- 1851995336
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Nurse 163W00000X
- License
- 91797 (PR)
- Practice address
- Kayenta Health Center
High Way 160 MP 394.3
Kayenta, AZ 86033 - Phone
- (928) 697-4000
- NPI assigned
- Nov 25, 2020
- 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 |
|---|---|---|---|
| 91797 | PR | MD | Registered Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 91797 | PR | Yes |
Addresses
Primary practice location
Kayenta Health Center
High Way 160 MP 394.3
Kayenta, AZ 86033
Mailing address
PO Box 384
Kayenta, AZ 86033-0384
Phone (909) 583-4929
Other practice location 1
High way 394
Kayenta, AZ 86033-0384
Phone (909) 583-4929
Other providers in Kayenta, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 25, 2020. 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.