Provider Demographics
NPI:1730710609
Name:RAPALO, DIANA (CRNP)
Entity type:Individual
Prefix:
First Name:DIANA
Middle Name:
Last Name:RAPALO
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10125 ASHBURTON LN STE 630
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20817-1729
Mailing Address - Country:US
Mailing Address - Phone:240-370-3773
Mailing Address - Fax:
Practice Address - Street 1:10215 FERNWOOD RD STE 630
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20817-1184
Practice Address - Country:US
Practice Address - Phone:240-449-3094
Practice Address - Fax:240-489-4415
Is Sole Proprietor?:No
Enumeration Date:2020-01-30
Last Update Date:2020-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MHR207501363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDR207501OtherSTATE OF MARYLAND LICENSE