Doctor Name: | DIANA L ERION |
NPI Number: | 1003176173 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | FNP-BC |
License Number: | 2012013585 |
Business Practice Address: | 1600 E Broadway Columbia, MO - 652015844 |
Business Phone Number: | 5738758838 |
Business Fax Number: | 5738758589 |
Mailing Address: | 1316 Old Highway 63 S, Suite 102 COLUMBIA |
State: | MO |
Postal Code: | 652016092 |
Phone Number: | 5738758838 |
Fax Number: | 5758758589 |
NPI Enumeration Date: | 05/23/2012 |
NPI Last Update Date: | 05/23/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 2012013585 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MO |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |