Individual
DIANE GOODMAN WAITS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
700 W MARKET ST, ATHENS, AL 35611-2457
(800) 893-9698
Mailing address
200 CORPORATE BLVD, SUITE 201, LAFAYETTE, LA 70508-3870
(800) 893-9698
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
1-035719
AL
Other
Enumeration date
11/17/2011
Last updated
02/02/2016
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