Individual
MRS. DIANA J STIDHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP
Contact information
Practice address
400 E MARTIN LUTHER KING BLVD, CINCINNATI, OH 45229
(513) 861-7313
Mailing address
5873 SIGMON WAY, FAIRFIELD, OH 45014-4847
(513) 829-0692
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
RN-197978
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2357051
—
OH
Enumeration date
03/09/2006
Last updated
07/08/2007
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