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Individual
DIANE S TANDY
Active
Individual
DIANE S TANDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM
Taxonomy
Speciality
Code
Description
License number
State
367A00000X
Advanced Practice Midwife
Primary
RN093246
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000651868C
—
GA
05
—
000651868D
—
GA
01
—
000651868D OR F
PEACHSTATE
GA
05
—
000651868F
—
GA
05
—
000651868K
—
GA
01
—
202I422022
MEDICARE - GEORGIA
GA
01
—
332884
WELLCARE
GA
01
—
5002152
AETNA
GA
Enumeration date
07/08/2006
Last updated
08/22/2013
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