DIANE L SPIVA CRNP NPI 1578632808

NPI Information

NPI: 1578632808
Provider Name: DIANE L SPIVA, CRNP
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Individual

Specialization: Family

PECOS Registration: Yes

Address:
10730 MEDLOCK BRIDGE RD STE 110
JOHNS CREEK, GA
ZIP 30097
Phone: (678) 344-8900
Get Directions

Diane L Spiva, CRNP is a family nurse practitioner in Johns Creek, GA. Diane L Spiva, CRNP NPI is 1578632808. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

10730 MEDLOCK BRIDGE RD STE 110
JOHNS CREEK, GA
ZIP 30097-638
Phone: (678) 344-8900
Fax: (678) 666-5201

The NPI 1578632808 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 11/8/2006 and was last updated on 3/18/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LA2200X	Nurse Practitioner	Adult Health	1-117580	ALABAMA	No
2	363LF0000X	Nurse Practitioner	Family	RN278076	GEORGIA	Yes
3	363LF0000X	Nurse Practitioner	Family	1-117580	ALABAMA	No
4	363LW0102X	Nurse Practitioner	Women's Health	1-117580	ALABAMA	No
5	367500000X	Nurse Anesthetist, Certified Registered		55532	KANSAS	No

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1-117580	OTHER	ALABAMA	CRNP LICENSE
2	55532	OTHER	KANSAS	RNA LICENSE
3	RN278076	OTHER	GEORGIA	APRN LICENSE
4	1391784012	OTHER	KANSAS	RN LICENSE
5	1-117580	OTHER	ALABAMA	RN LICENSE
6	RN278076	OTHER	GEORGIA	RN LICENSE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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