Basic Information
| Provider Information | |||||||||
| NPI: | 1558425009 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | NOWAKOWSKI | ||||||||
| FirstName: | DIANE | ||||||||
| MiddleName: | M | ||||||||
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| Credential: | ARNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1160 SURF RD | ||||||||
| Address2: | |||||||||
| City: | SINGER ISLAND | ||||||||
| State: | FL | ||||||||
| PostalCode: | 334043848 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5614940245 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1150 45TH ST | ||||||||
| Address2: | |||||||||
| City: | WEST PALM BEACH | ||||||||
| State: | FL | ||||||||
| PostalCode: | 334072361 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5615145300 | ||||||||
| FaxNumber: | 5615145540 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/20/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LX0001X | ARNP3042932 | FL | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Obstetrics & Gynecology |
No ID Information.