Individual
MS. DIANA GUSTAFSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
5100 W TILGHMAN ST STE 315, ALLENTOWN, PA 18104-9166
(610) 395-4044
(610) 395-5693
Mailing address
PO BOX 783497, PHILADELPHIA, PA 19178-3497
(610) 395-4044
(610) 395-5693
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN-291123-L
PA
367500000X
Certified Registered Nurse Anesthetist
Primary
041655
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0768820000
IBC
PA
01
—
50058818
CAPITAL ADVANTAGE
PA
01
—
632005
HIGHMARK
PA
01
—
95425
GEISINGER
PA
Enumeration date
04/08/2006
Last updated
11/26/2025
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