Provider Demographics
NPI:1295096774
Name:MORGAN, DIANA LYNN
Entity type:Individual
Prefix:
First Name:DIANA
Middle Name:LYNN
Last Name:MORGAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2820 AIRPORT RD
Mailing Address - Street 2:#8
Mailing Address - City:CARSON CITY
Mailing Address - State:NV
Mailing Address - Zip Code:89706-1166
Mailing Address - Country:US
Mailing Address - Phone:775-884-3288
Mailing Address - Fax:
Practice Address - Street 1:2820 AIRPORT RD
Practice Address - Street 2:#8
Practice Address - City:CARSON CITY
Practice Address - State:NV
Practice Address - Zip Code:89706-1166
Practice Address - Country:US
Practice Address - Phone:775-884-3288
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-31
Last Update Date:2012-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner