| NPI | 1154891257 |
|---|---|
| Former Name | DIANNA JEANNE PUCKETT |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: CO APN.0993352-NP) |
| Enumeration Date | 2018-11-30 |
| Last Update Date | 2022-08-08 |