Individual
DIANA C. MUDD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
500 WINDERLEY PL STE 115, MAITLAND, FL 32751-7406
(407) 581-9180
(865) 560-7066
Mailing address
500 WINDERLEY PL STE 115, MAITLAND, FL 32751-7406
(407) 581-9180
(865) 560-7066
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
ARNP1089012
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0347884 00
—
FL
01
—
430048790
RAILROAD MEDICARE
—
01
—
G1702
BCBS
FL
Enumeration date
07/21/2006
Last updated
06/22/2019
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