Provider Demographics
NPI:1447452933
Name:HERMANN, DIANA (LAC)
Entity type:Individual
Prefix:MS
First Name:DIANA
Middle Name:
Last Name:HERMANN
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:308 S HOWES ST
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80521-2710
Mailing Address - Country:US
Mailing Address - Phone:970-416-9600
Mailing Address - Fax:
Practice Address - Street 1:308 S HOWES ST
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80521-2710
Practice Address - Country:US
Practice Address - Phone:970-416-9600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO768171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist