Doctor Name: | DIANE M SCHWIND |
NPI Number: | 1104854470 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | NP |
License Number: | |
Business Practice Address: | 2044 Madison Ave Suite 15 Granite City, IL - 620404641 |
Business Phone Number: | 6184511500 |
Business Fax Number: | |
Mailing Address: | 2044 Madison Ave, Suite 15 GRANITE CITY |
State: | IL |
Postal Code: | 620404641 |
Phone Number: | 6184511500 |
Fax Number: | |
NPI Enumeration Date: | 06/28/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LA2200X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Adult Health |
Taxonomy Definition: |