Provider Demographics
NPI:1609236850
Name:SHILLING, DIANE NICOLE (ARNP)
Entity type:Individual
Prefix:MRS
First Name:DIANE
Middle Name:NICOLE
Last Name:SHILLING
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:MS
Other - First Name:DIANE
Other - Middle Name:NICOLE
Other - Last Name:GIBSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP
Mailing Address - Street 1:249 CENTRAL PARK AVE STE 300
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23462-3271
Mailing Address - Country:US
Mailing Address - Phone:877-267-4253
Mailing Address - Fax:877-395-9003
Practice Address - Street 1:249 CENTRAL PARK AVE
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23462-3099
Practice Address - Country:US
Practice Address - Phone:877-267-4253
Practice Address - Fax:877-395-9003
Is Sole Proprietor?:No
Enumeration Date:2016-03-01
Last Update Date:2024-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9266308363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily