Provider Demographics
NPI:1548697634
Name:BYRD, DIANA ELAINE (NP)
Entity type:Individual
Prefix:MRS
First Name:DIANA
Middle Name:ELAINE
Last Name:BYRD
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12543 N HIGHWAY 83
Mailing Address - Street 2:SUITE 228
Mailing Address - City:PARKER
Mailing Address - State:CO
Mailing Address - Zip Code:80134-8811
Mailing Address - Country:US
Mailing Address - Phone:303-805-5528
Mailing Address - Fax:
Practice Address - Street 1:12543 N HIGHWAY 83
Practice Address - Street 2:SUITE 228
Practice Address - City:PARKER
Practice Address - State:CO
Practice Address - Zip Code:80134-8811
Practice Address - Country:US
Practice Address - Phone:303-805-5528
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-03
Last Update Date:2013-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAPN.0990921-NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily