Individual
DIANE KUPENSKY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN CNS
Contact information
Practice address
1044 BELMONT AVE, YOUNGSTOWN, OH 44504-1006
(330) 480-2199
(330) 480-2750
Mailing address
1044 BELMONT AVE, YOUNGSTOWN, OH 44504-1006
(330) 480-2199
(330) 480-2071
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN144457
OH
364S00000X
Clinical Nurse Specialist
Primary
COA06136NS
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0063795
—
OH
05
—
2619376
—
OH
01
—
H155490
MEDICARE PTAN
OH
Enumeration date
11/30/2006
Last updated
12/08/2016
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