Individual
DIANE L DUNTZE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ANP
Contact information
Practice address
HC 1 BOX 335, GAKONA, AK 99586-9702
(907) 822-3937
(907) 822-3937
Mailing address
HC 1 BOX 335, GAKONA, AK 99586-9702
(907) 822-3937
(907) 822-3937
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
686
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02D1010983
CLIA#
AK
01
—
11406
REGISTERED NURSE
AK
01
—
686
ANP LICENSE #
AK
01
—
K151740
MEDICARE PTAN
AK
05
—
NP0247
—
AK
05
—
NP02471
—
AK
05
—
NP02472
—
AK
05
—
NP02473
—
AK
05
—
PH02473
—
AK
Enumeration date
03/16/2007
Last updated
03/07/2023
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