Individual
MRS. DIANE LYNN DESTEFANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
209009671
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
209009671
ILLINOIS APN LICENSE
IL
01
—
3007204
KY LIC
KY
01
—
71003775A
IN LICENSE
IN
Enumeration date
10/19/2011
Last updated
06/10/2014
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
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