Individual
DIANE M. NITTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3443 S NATIONAL AVE, SPRINGFIELD, MO 65807-7308
(417) 269-2000
(417) 269-2038
Mailing address
PO BOX 505673, SAINT LOUIS, MO 63150-5673
(417) 730-6430
(417) 269-7567
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
100939
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
208003004
—
MO
Enumeration date
10/05/2006
Last updated
05/14/2024
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