Individual provider · Type 1 NPI
Diana J. Stidham, CPNP
Pediatric Nurse Practitioner · Cincinnati, OH
NPI number
1104894971
Active
Practice location
400 E Martin Luther King Blvd
Cincinnati, OH 45229
Mailing address
5873 Sigmon Way
Fairfield, OH 45014-4847
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Pediatric Nurse Practitioner Primary | 363LP0200X | RN-197978 (OH) |
Pediatric Nurse Practitioner: Definition to come...
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About NPI 1104894971
Diana J. Stidham, CPNP's National Provider Identifier is 1104894971, issued on Mar 9, 2006. The primary taxonomy on file is Pediatric Nurse Practitioner (363LP0200X), and the practice location is in Cincinnati, OH. The record was last updated on Jul 8, 2007.