Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | 11009911 | FL |
N | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | RN273785 | GA |
NPI | 1003434341 |
---|---|
Provider Name | Patricia Dianne Didier |
First Address | Jacksonville, FL 32216-2753 |
Second Address | Jacksonville, FL 32216-2753 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/07/2020 |
Last Update Date | 19/02/2021 |