Manderson, Diana Hope

Manderson, Diana Hope is an individual health care provider with primary practice located at 136 Prairie Ridge Dr , St Augustine FL 32092-1852. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Pediatrics, Physician Assistants & Advanced Practice Nursing Providers / Family. Physician Assistants & Advanced Practice Nursing Providers / Pediatrics is her primary health care specialty. Manderson, Diana Hope can be contacted via phone (904) 404-6626.

Contact Information

Primary practice address
136 Prairie Ridge Dr St Augustine FL 32092-1852
Phone: (904) 404-6626
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Pediatrics 363LP0200X 11026420 Florida
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X APRN11026420 Florida

Profile Details

NPI number 1114619921
LBN Legal business name Manderson, Diana Hope
Credentials Advanced Practice Registered Nurse (APRN)
Entity Individual
Sole proprietor 1 No
Enumeration date May 22nd, 2023
Last updated Dec 7th, 2025 - about last year

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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