Individual
MRS. DIANE PERINE FONTANA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
200 HAWTHORNE LN, CHARLOTTE, NC 28204-2515
(704) 384-4239
(704) 384-5636
Mailing address
200 HAWTHRONE LN, CHARLOTTE, NC 28204-2515
(704) 384-4239
(704) 384-5636
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
182054
NC
367500000X
Certified Registered Nurse Anesthetist
2013006661
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8051588
—
NC
Enumeration date
07/20/2005
Last updated
05/14/2024
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