Fontana, Diane Perine

Fontana, Diane Perine is an individual health care provider with primary practice located at 200 Hawthorne Ln , Charlotte NC 28204-2515. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as her primary health care specialty. Fontana, Diane Perine can be contacted via phone (704) 384-4239.

Contact Information

Primary practice address
200 Hawthorne Ln Charlotte NC 28204-2515
Phone: (704) 384-4239
Fax: (704) 384-5636
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 2013006661 Missouri
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 182054 North Carolina

Profile Details

NPI number 1114926110
LBN Legal business name Fontana, Diane Perine
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 20th, 2005
Last updated May 14th, 2024 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1114926110 NPPES
North Carolina MEDICAID 8051588

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