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Individual
DIANE LACROIX
Active
Individual
DIANE LACROIX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
4704172544
MI
363L00000X
Nurse Practitioner
95024219
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4653159
—
MI
05
—
4653168
—
MI
05
—
4653177
—
MI
01
—
DL172544
BLUE CROSS BLUE SHIELD
—
01
—
P00157330
RAILROAD MEDICARE
—
Enumeration date
11/23/2005
Last updated
08/24/2023
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