1396097630

Everything you always wanted to know about MRS. THORNLEY DIANA AMY ACNP-BC but were afraid to ask.

MRS. THORNLEY DIANA AMY ACNP-BC

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Provider Prefix Provider Last Name Provider Middle Name Provider First Name Provider Credential
MRS. THORNLEY DIANA AMY ACNP-BC
Gender:
Female
Enumeration date:
2012-10-10
Last update date:
2012-10-10
Current as of:
Is sole proprietor?:
No
Is organization subpart?:
No
In PECOS?:
No
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Identifiers

identifier description issuer state

Taxonomies

Taxonomy State License Number Primary?
363LA2100X Acute Care ID NP-1158A Y

Phone Numbers

Type Number
Mailing Address Telephone Number 2085892352
Practice Location Address Telephone Number 2085892352
Mailing Address Fax Number 2087540426
Practice Location Address Fax Number 2087540426

Addresses

Type Address City State Postal Country
Mailing Address 3412 E 400 N LEWISVILLE ID 83431 ID
Practice Location Address 3100 CHANNING WAY IDAHO FALLS ID 83404 ID

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