| Doctor Name: | DIANE BOYENGA |
| NPI Number: | 1487099933 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | R.N. |
| License Number: | R 87680-7 |
| Business Practice Address: | 2 Roundwind Rd Luverne, MN - 561561300 |
| Business Phone Number: | 5072835066 |
| Business Fax Number: | 5072835074 |
| Mailing Address: | 1924 41st St, ELLSWORTH |
| State: | MN |
| Postal Code: | 561294085 |
| Phone Number: | 5072835066 |
| Fax Number: | 5072835074 |
| NPI Enumeration Date: | 05/09/2013 |
| NPI Last Update Date: | 05/09/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WC1500X |
| License Number: | R 87680-7 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MN |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Community Health |
| Taxonomy Definition: | |