Individual
DIANA JOHNS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2248 W ROSEBUD LN, COEUR D ALENE, ID 83814-7312
(907) 687-6248
Mailing address
2248 W ROSEBUD LN, COEUR D ALENE, ID 83814-7312
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
6425
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
MD0478
—
AK
Enumeration date
07/23/2006
Last updated
10/10/2013
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