| Doctor Name: | DIANA CONNELL |
| NPI Number: | 1851550776 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | RN |
| License Number: | 179402 |
| Business Practice Address: | 12000 Stone Lake Road Dulce, NM - 875280187 |
| Business Phone Number: | 5057593291 |
| Business Fax Number: | |
| Mailing Address: | Po Box 187, DULCE |
| State: | NM |
| Postal Code: | 875280187 |
| Phone Number: | 5057593291 |
| Fax Number: | |
| NPI Enumeration Date: | 06/05/2008 |
| NPI Last Update Date: | 06/05/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WC1500X |
| License Number: | 179402 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CO |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Community Health |
| Taxonomy Definition: | |