Provider Demographics
NPI:1942011382
Name:BLASCO, DIANA
Entity type:Individual
Prefix:
First Name:DIANA
Middle Name:
Last Name:BLASCO
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 1:484 SUSSEX DR SW
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35824-1342
Mailing Address - Country:US
Mailing Address - Phone:256-606-9857
Mailing Address - Fax:
Practice Address - Street 1:484 SUSSEX DR SW
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35824-1342
Practice Address - Country:US
Practice Address - Phone:256-606-9857
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-15
Last Update Date:2025-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula