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Individual

DIANA L TOMLIANOVICH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PMHNP-BC

Contact information

Practice address
2920 VETERANS MEMORIAL DR, MOUNT VERNON, IL 62864-5924
(618) 244-6544
(618) 244-6577
Mailing address
PO BOX 155, CHRISTOPHER, IL 62822-0155
(618) 724-2401

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
209.014810
IL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
209.014810
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
214881
MEDICARE GROUP PTAN
IL
Enumeration date
04/06/2017
Last updated
02/05/2026
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