| Doctor Name: | DIANE MARIE O'CONNOR |
| NPI Number: | 1376735670 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | FNP |
| License Number: | RN188468 |
| Business Practice Address: | 690 Dallas Hwy Suite 101 Villa Rica, GA - 301801264 |
| Business Phone Number: | 7704590620 |
| Business Fax Number: | 7704567604 |
| Mailing Address: | 44 Fenway Ct, NEWNAN |
| State: | GA |
| Postal Code: | 302655536 |
| Phone Number: | 6783788887 |
| Fax Number: | |
| NPI Enumeration Date: | 08/10/2007 |
| NPI Last Update Date: | 04/27/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | RN188468 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | GA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |