Provider Demographics
NPI:1871881581
Name:HOLBEIN, DIANA (CRNP)
Entity type:Individual
Prefix:
First Name:DIANA
Middle Name:
Last Name:HOLBEIN
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:DIANA
Other - Middle Name:
Other - Last Name:MARUCCI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNP
Mailing Address - Street 1:3401 CIVIC CENTER BLVD
Mailing Address - Street 2:CARDIAC CARE UNIT
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19104-4319
Mailing Address - Country:US
Mailing Address - Phone:215-590-1000
Mailing Address - Fax:215-590-6690
Practice Address - Street 1:3401 CIVIC CENTER BLVD
Practice Address - Street 2:CARDIAC CARE UNIT
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104-4319
Practice Address - Country:US
Practice Address - Phone:215-590-1000
Practice Address - Fax:215-590-6690
Is Sole Proprietor?:No
Enumeration Date:2011-07-14
Last Update Date:2019-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9335360363L00000X
NJ26NJ00335200363LP0200X
PASP014659363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLFW150ZMedicare PIN