Individual
DIANA M VANDEGRIFT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
2350 MIAMI VALLEY DR STE 500, CENTERVILLE, OH 45459-4780
(937) 293-1622
(937) 245-6308
Mailing address
6680 POE AVE STE 200, DAYTON, OH 45414-2855
(937) 280-8400
(937) 280-8373
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
0030600
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0482118
—
OH
Enumeration date
02/05/2022
Last updated
10/06/2022
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