Provider Demographics
NPI:1225855000
Name:CURPHY, DIANA (ILL REGISTER NURSE)
Entity type:Individual
Prefix:
First Name:DIANA
Middle Name:
Last Name:CURPHY
Suffix:
Gender:F
Credentials:ILL REGISTER NURSE
Other - Prefix:
Other - First Name:DIANA
Other - Middle Name:
Other - Last Name:CURPHY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:IA REGISTERED NURSE
Mailing Address - Street 1:2200 3RD AVE
Mailing Address - Street 2:
Mailing Address - City:ROCK ISLAND
Mailing Address - State:IL
Mailing Address - Zip Code:61201-8840
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2200 3RD AVE
Practice Address - Street 2:
Practice Address - City:ROCK ISLAND
Practice Address - State:IL
Practice Address - Zip Code:61201-8840
Practice Address - Country:US
Practice Address - Phone:309-779-7500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-24
Last Update Date:2024-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA117516163WP0808X
IL041254848163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health