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Contact Information

DIANNE K MAYTHORNE, ANP
1363 W SPRUCE AVE
WASILLA, AK99654-5327
 Phone: 907-376-2411
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Family

363LF0000X 50 Nurse Practitioner
 

Home Health

163WH0200X
Indicates primary specialty

NPI Profile & details for DIANNE K MAYTHORNE · (Female)

NPI # 1518185388
Status Active
Credentials ANP (Adult Nurse Practitioner)
Entity Individual
Enumeration date 04/24/2007
Last updated 06/19/2020 - About 6 years ago
Sole proprietor 1 No
Identifiers
  • AK License # 1223
  • AK License # 17770
  • AK Medicaid HH2487
  • AK Medicaid NA2487
  • AK Medicaid NP0193
  • AK Medicaid PCG214
  • AK Other 1912011842 AGENCY NPI NUMBER
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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