Individual
DIANA HOPE MANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
136 PRAIRIE RIDGE DR, ST AUGUSTINE, FL 32092-1852
(904) 404-6626
Mailing address
136 PRAIRIE RIDGE DR, ST AUGUSTINE, FL 32092-1852
(904) 404-6626
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
APRN11026420
FL
363LP0200X
Pediatric Nurse Practitioner
Primary
11026420
FL
Other
Enumeration date
05/22/2023
Last updated
12/07/2025
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