Provider Demographics
NPI:1174046619
Name:REMENAR, DIANA JO (PA-C)
Entity type:Individual
Prefix:MS
First Name:DIANA
Middle Name:JO
Last Name:REMENAR
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Gender:F
Credentials:PA-C
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Mailing Address - Street 1:10225 HICKORYWOOD HILL AVE
Mailing Address - Street 2:
Mailing Address - City:HUNTERSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28078-3430
Mailing Address - Country:US
Mailing Address - Phone:704-457-9292
Mailing Address - Fax:
Practice Address - Street 1:10420 PARK RD STE 300
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28210-8502
Practice Address - Country:US
Practice Address - Phone:980-237-4766
Practice Address - Fax:980-404-2274
Is Sole Proprietor?:No
Enumeration Date:2017-07-17
Last Update Date:2021-09-23
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Provider Licenses
StateLicense IDTaxonomies
NC0010-07456363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant