Individual
SUSAN CLARE DIAGANA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
309 WEST AVE, NORTH AUGUSTA, SC 29841-3800
(706) 396-3570
Mailing address
199 MUDDY BRANCH RD, AIKEN, SC 29805-8365
(317) 730-1185
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
27305
GA
363L00000X
Nurse Practitioner
Primary
27305
GA
363LF0000X
Family Nurse Practitioner
71002324
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200848040
—
IN
Enumeration date
01/22/2007
Last updated
05/07/2024
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