Diane H Puppolo, APRN

Primary specialty

Adult Psychiatric/Mental Health Clinical Nurse SpecialistTaxonomy code 364SP0809X

License

000847 Issued in CT

Practice address

883 Paddock Ave
Meriden, CT 06450-7044

Phone

(203) 630-5314

NPI assigned

Apr 13, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Specialist, Nurse Practitioner

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Rushford Center, Inc.

  • Psychologist
  • Meriden, CT
  • NPI 1275541005
  NPD (past)

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

{
    "created_epoch": "1176422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456876800000",
    "number": "1982828489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "883 PADDOCK AVE",
            "city": "MERIDEN",
            "state": "CT",
            "postal_code": "064507044",
            "telephone_number": "203-630-5314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "883 PADDOCK AVE",
            "city": "MERIDEN",
            "state": "CT",
            "postal_code": "064507044",
            "telephone_number": "203-630-5314"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUPPOLO",
        "first_name": "DIANE",
        "middle_name": "H",
        "name_prefix": "Miss",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-13",
        "last_updated": "2016-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SP0809X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health, Adult",
            "state": "CT",
            "license": "000847",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MED ID TYPE UNSPECIFIED",
            "identifier": "890000489",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Premier Dental P C
• Premier Eyecare
• Premier Eyecare of Meriden LLC.
• James Price
• Laura Prior, APRN
• Puranik Family Medical Center LLC
• Prakash N Puranik, M.D.
• Lila Mae Purvis
• Paul Pyo, M.D.
• Erica Lauren Quinones, DMD

• Adult Psychiatric/Mental Health Clinical Nurse Specialist in Meriden, CT
• Providers in Meriden, CT by specialty
• Adult Psychiatric/Mental Health Clinical Nurse Specialist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2016; 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.