Provider Demographics
NPI:1144468315
Name:WALKER, DIANE MARIE (RD LDN)
Entity type:Individual
Prefix:MRS
First Name:DIANE
Middle Name:MARIE
Last Name:WALKER
Suffix:
Gender:F
Credentials:RD LDN
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Mailing Address - Street 1:P.O. BOX 5001
Mailing Address - Street 2:30 LOCUST STREET COOLEY DICKINSON HOSPITAL
Mailing Address - City:NORTHAMPTON
Mailing Address - State:MA
Mailing Address - Zip Code:01060-5001
Mailing Address - Country:US
Mailing Address - Phone:413-582-2650
Mailing Address - Fax:413-582-2933
Practice Address - Street 1:30 LOCUST STREET
Practice Address - Street 2:COOLEY DICKINSON HOSPITAL
Practice Address - City:NORTHAMPTON
Practice Address - State:MA
Practice Address - Zip Code:01060-5001
Practice Address - Country:US
Practice Address - Phone:413-582-2650
Practice Address - Fax:413-582-2933
Is Sole Proprietor?:No
Enumeration Date:2009-01-27
Last Update Date:2009-01-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA374133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAMT0258Medicare PIN