Individual
DIANE TRUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
12511 WORLD PLAZA LN BLDG 50, FORT MYERS, FL 33907-3991
(239) 939-2622
(239) 939-0151
Mailing address
1223 BARNSDALE ST, LEHIGH ACRES, FL 33936-4840
(239) 939-2622
(239) 939-0151
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
ARNP408312
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
304448300
—
FL
01
—
430019223
RAILROAD MEDICARE
—
01
—
G1022Z
BC BS FL
—
Enumeration date
02/16/2006
Last updated
02/28/2013
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