Individual
DIANA LYNN BRASKETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
C.P.N.P.
Contact information
Practice address
1856 E FLORENCE BLVD STE 1, CASA GRANDE, AZ 85122-5303
(520) 836-5036
Mailing address
PO BOX 10097, CASA GRANDE, AZ 85130-0020
(520) 836-3446
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
AP3069
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
521360
—
AZ
01
—
AP3069
AZ STATE BPARD OF NURSING
AZ
01
—
Z139286
ARIZONA MEDICARE FARGO PART B
AZ
Enumeration date
06/30/2008
Last updated
02/25/2022
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