Individual
DIANA SHULL ORTIZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.N.
Contact information
Practice address
950 CAMPBELL AVE, WEST HAVEN, CT 06516-2770
(203) 932-5711
Mailing address
725 MORRIS LANDING RD, HOLLY RIDGE, NC 28445-7608
(910) 803-2090
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
86910
NC
163W00000X
Registered Nurse
R38363
CT
Other
Enumeration date
08/10/2015
Last updated
08/10/2015
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