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Individual

DIANA S BROYLES

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
1000 W MORENO ST, PENSACOLA, FL 32501-2316
(850) 437-8390
(850) 437-8394
Mailing address
PO BOX 10824, BIRMINGHAM, AL 35202-0824
(205) 322-1808
(205) 322-1851

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
ARNP2040502
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
59170250
BLUE SHIELD
AL
01
59170251
BLUE SHIELD
AL
01
G2613
BLUE SHIELD
FL
01
P00148698
PALMETTO GBA - RR MEDICAR
Enumeration date
05/12/2006
Last updated
07/08/2007
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