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Individual

MRS. DIANNA MARIE PROKUPEK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ARNP

Contact information

Practice address
1408 EAST 10TH ST, ATLANTIC, IA 50022
(712) 243-2606
(712) 243-2688
Mailing address
1408 EAST 10TH ST, ATLANTIC, IA 50022
(712) 243-2606
(712) 243-2688

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
G087587
IA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0464800
IA
Enumeration date
02/02/2006
Last updated
07/16/2010
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