Individual
MS. DIANE L WATERHOUSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
601 CHILDRENS LN, NORFOLK, VA 23507-1971
(757) 668-9222
(757) 668-7568
Mailing address
601 CHILDRENS LN, NORFOLK, VA 23507-1971
(757) 668-7000
(757) 668-9691
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
0024115462
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
007785828
—
VA
Enumeration date
06/17/2006
Last updated
07/09/2023
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