Provider Demographics
NPI:1609624154
Name:SULEYMANOVA, DIANA (MSN-PH, APRN, FNP-C)
Entity type:Individual
Prefix:
First Name:DIANA
Middle Name:
Last Name:SULEYMANOVA
Suffix:
Gender:F
Credentials:MSN-PH, APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 E BELL RD APT 1027
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85022-3172
Mailing Address - Country:US
Mailing Address - Phone:602-722-8770
Mailing Address - Fax:
Practice Address - Street 1:8825 N 23RD AVE
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85021-4147
Practice Address - Country:US
Practice Address - Phone:888-256-3814
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-09
Last Update Date:2024-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ303160363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily