| Glenda Laverne Diaz, FNP | |
|
41 Spring Bok Ln, Thomasville, GA 31792-0691 | |
| (229) 224-4793 | |
| Not Available |
| Full Name | Glenda Laverne Diaz |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner - Family |
| Location | 41 Spring Bok Ln, Thomasville, Georgia |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932670247 | NPI | - | NPPES |
| RN155906 | Other | GA | NEW GRADUATED FAMILYNURSE PRACTITIONER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363LF0000X | Nurse Practitioner - Family | RN155906 (Georgia) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | APRN11002023 (Florida) | Primary |
| Entity Name | Patients First Lake Ella Medical Center P A |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1164524039 PECOS PAC ID: 4082760566 Enrollment ID: O20090924000578 |
| Entity Name | Wound Technology Network, Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1962601393 PECOS PAC ID: 4486892296 Enrollment ID: O20130605000626 |
| Entity Name | Wt Health Of Florida Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1982434106 PECOS PAC ID: 5294268124 Enrollment ID: O20241030001547 |
| Mailing Address | Practice Location Address |
|---|---|
| Glenda Laverne Diaz, FNP 41 Spring Bok Ln, Thomasville, GA 31792-0691 Ph: (229) 224-4793 | Glenda Laverne Diaz, FNP 41 Spring Bok Ln, Thomasville, GA 31792-0691 Ph: (229) 224-4793 |
Mrs. Melanie Jai Balfour, ARNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 100 S Madison St, Thomasville, GA 31792 Phone: 229-236-0831 Fax: 229-236-0871 | |
Mrs. Courtnay Kelly Perryman, PMHNP-BC Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1102 Smith Ave Ste K, Thomasville, GA 31792 Phone: 229-225-4335 | |
Ms. Allen R Lybrook, APRN,BC Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 116 Mimosa Dr, Thomasville, GA 31792 Phone: 229-226-5788 Fax: 229-226-2548 | |
Mrs. Patrice Gunter Bullock, MSN, APRN-C Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 115 Circle Dr, Thomasville, GA 31792 Phone: 229-225-9830 | |
Mary Racheal Havens, ARNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 454 Smith Ave, Thomasville, GA 31792 Phone: 229-227-5510 | |
Kristin F Deutsch, N.P. Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 112 Mimosa Dr, Thomasville, GA 31792 Phone: 229-227-0045 Fax: 229-227-9120 | |
Cecilie Cowie, NP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 900 Gordon Ave, Thomasville, GA 31792 Phone: 229-226-0125 Fax: 229-226-0195 |