Individual
GLENDA LAVERNE DIAZ
Active
Individual
GLENDA LAVERNE DIAZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
APRN11002023
FL
363LF0000X
Family Nurse Practitioner
RN155906
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RN155906
NEW GRADUATED FAMILYNURSE PRACTITIONER
GA
Enumeration date
12/12/2018
Last updated
03/09/2022
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