Provider Demographics
NPI:1700997913
Name:FEATHERS, DIANA SUE (RN)
Entity type:Individual
Prefix:MS
First Name:DIANA
Middle Name:SUE
Last Name:FEATHERS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MS
Other - First Name:DIANA
Other - Middle Name:SUE
Other - Last Name:KEMBLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:401 E DETROIT
Mailing Address - Street 2:
Mailing Address - City:PONCA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:74601
Mailing Address - Country:US
Mailing Address - Phone:580-765-5692
Mailing Address - Fax:
Practice Address - Street 1:200 WHITE EAGLE DRIVE
Practice Address - Street 2:
Practice Address - City:PONCA CITY
Practice Address - State:OK
Practice Address - Zip Code:74601
Practice Address - Country:US
Practice Address - Phone:580-765-2501
Practice Address - Fax:580-765-6348
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKROO 33969163WD0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WD0400XNursing Service ProvidersRegistered NurseDiabetes Educator