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Individual
MRS. DIANA DISTASIO
Active
Individual
MRS. DIANA DISTASIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN257310L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1007678420038
—
PA
05
—
1015956900004
—
PA
05
—
1015956900005
—
PA
Enumeration date
04/09/2007
Last updated
04/25/2016
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