Provider Demographics
NPI:1730891953
Name:RAM, DIANE (RN)
Entity type:Individual
Prefix:
First Name:DIANE
Middle Name:
Last Name:RAM
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 1:755 MOUNT VERNON HWY NE STE 530
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30328-4287
Mailing Address - Country:US
Mailing Address - Phone:404-252-7970
Mailing Address - Fax:
Practice Address - Street 1:755 MOUNT VERNON HWY NE STE 530
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30328-4287
Practice Address - Country:US
Practice Address - Phone:404-252-7970
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-19
Last Update Date:2022-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA134891163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse