Individual
MS. DIANA WAKELYN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
2240 WINROW AVE, FORT HUACHUCA, AZ 85613
(520) 533-9950
(520) 533-6712
Mailing address
2927 PLAYER AVE, SIERRA VISTA, AZ 85650-6601
(321) 848-3713
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN5192025
FL
Other
Enumeration date
03/29/2017
Last updated
03/29/2017
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