Provider Demographics
NPI:1043931140
Name:MUSSELWHITE, DIANE STEPHANIE
Entity type:Individual
Prefix:MRS
First Name:DIANE
Middle Name:STEPHANIE
Last Name:MUSSELWHITE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2090 RIVER REACH DR APT 43
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34104-5276
Mailing Address - Country:US
Mailing Address - Phone:954-702-3097
Mailing Address - Fax:
Practice Address - Street 1:2090 RIVER REACH DR APT 43
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34104-5276
Practice Address - Country:US
Practice Address - Phone:954-702-3097
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-07
Last Update Date:2022-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9435041163WH1000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH1000XNursing Service ProvidersRegistered NurseHospice
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL957254542OtherUNITED HEALTH CARE