Individual
DIANA MAY LABUMBARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ACNP-BC/GNP-BC
Contact information
Practice address
1133 MEDICAL DR, TYLER, TX 75701-2130
(903) 595-5486
(903) 595-5128
Mailing address
1133 MEDICAL DR, TYLER, TX 75701-2130
(903) 595-5486
(903) 595-5128
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
AP126696
TX
363LA2100X
Acute Care Nurse Practitioner
Primary
AP126696
TX
363LA2200X
Adult Health Nurse Practitioner
AP126696
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
342112502
—
TX
Enumeration date
05/17/2013
Last updated
11/08/2017
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