Provider Demographics
NPI:1093025272
Name:DIEHL, ANN BRIDGET (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:ANN
Middle Name:BRIDGET
Last Name:DIEHL
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:ANN
Other - Middle Name:BRIDGET
Other - Last Name:NEBZYDOSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:918 GREAT BEND TPKE
Mailing Address - Street 2:
Mailing Address - City:PLEASANT MOUNT
Mailing Address - State:PA
Mailing Address - Zip Code:18453-4547
Mailing Address - Country:US
Mailing Address - Phone:570-352-5305
Mailing Address - Fax:
Practice Address - Street 1:254 BROOKLYN ST
Practice Address - Street 2:
Practice Address - City:CARBONDALE
Practice Address - State:PA
Practice Address - Zip Code:18407-2824
Practice Address - Country:US
Practice Address - Phone:570-282-3347
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-10-20
Last Update Date:2014-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical