Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | 101.0084113 | VT |
Y | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | 166641 | MA |
NPI | 1306990346 |
---|---|
Provider Name | Ms. Diane M Szlachetka |
First Address | Hyde Park, VT 05655-4442 |
Second Address | Hyde Park, VT 05655-4442 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/01/2007 |
Last Update Date | 08/07/2013 |