Provider Demographics
NPI:1730875964
Name:STOUGHTON, DIANA KAY (RN)
Entity type:Individual
Prefix:
First Name:DIANA
Middle Name:KAY
Last Name:STOUGHTON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1227 260TH ST
Mailing Address - Street 2:
Mailing Address - City:FORT SCOTT
Mailing Address - State:KS
Mailing Address - Zip Code:66701-1864
Mailing Address - Country:US
Mailing Address - Phone:620-224-1199
Mailing Address - Fax:
Practice Address - Street 1:902 HORTON ST
Practice Address - Street 2:
Practice Address - City:FORT SCOTT
Practice Address - State:KS
Practice Address - Zip Code:66701-2438
Practice Address - Country:US
Practice Address - Phone:785-350-4752
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-12
Last Update Date:2023-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS13-73435-082163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management