Individual
DIANNE LYNN TAO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
WHNP
Contact information
Practice address
938 MEZZANINE DR STE B, LAFAYETTE, IN 47905-8641
(765) 448-8000
(765) 838-6302
Mailing address
PO BOX 5545, LAFAYETTE, IN 47903-5545
(765) 448-8000
Taxonomy
Speciality
Code
Description
License number
State
363LX0001X
Obstetrics & Gynecology Nurse Practitioner
Primary
71000014A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000321052
ANTHEM PROVIDER NUMBER
IN
05
—
200096800
—
IN
01
—
9397703
PHCS PID NUMBER
IN
Enumeration date
03/20/2006
Last updated
07/24/2012
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