Provider Demographics
NPI:1366271520
Name:DIAMONESSENCE
Entity type:Organization
Organization Name:DIAMONESSENCE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FORENSIC NURSE OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JERI
Authorized Official - Middle Name:A
Authorized Official - Last Name:DERMANELIAN
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:725-250-6544
Mailing Address - Street 1:4055 SPENCER ST STE 228
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89119-9313
Mailing Address - Country:US
Mailing Address - Phone:725-250-6544
Mailing Address - Fax:702-734-0879
Practice Address - Street 1:4055 SPENCER ST STE 228
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89119-9313
Practice Address - Country:US
Practice Address - Phone:725-250-6544
Practice Address - Fax:702-734-0879
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ROSEHEART
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-07-29
Last Update Date:2024-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Single Specialty