Provider Demographics
NPI:1548297864
Name:DIAMOND, CAROLE A (MSN, PMHNP-BC, FNP-C)
Entity type:Individual
Prefix:MS
First Name:CAROLE
Middle Name:A
Last Name:DIAMOND
Suffix:
Gender:F
Credentials:MSN, PMHNP-BC, FNP-C
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:4128 MAIN STREET
Mailing Address - Street 2:PO BOX 503
Mailing Address - City:TIMNATH
Mailing Address - State:CO
Mailing Address - Zip Code:80547-9997
Mailing Address - Country:US
Mailing Address - Phone:623-231-7831
Mailing Address - Fax:970-815-3775
Practice Address - Street 1:1318 S COLLEGE AVE UNIT 2
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80524-4175
Practice Address - Country:US
Practice Address - Phone:970-237-5455
Practice Address - Fax:970-815-3775
Is Sole Proprietor?:No
Enumeration Date:2006-06-26
Last Update Date:2019-06-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CO130431 RN; 3548 NP363LF0000X, 363LX0001X
CORXN.0002013-NP363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology