Provider Demographics
NPI:1407364193
Name:ABEL, DIANNE J (PA-C)
Entity Type:Individual
Prefix:
First Name:DIANNE
Middle Name:J
Last Name:ABEL
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PSC 477 BOX 2
Mailing Address - Street 2:
Mailing Address - City:FPO
Mailing Address - State:AP
Mailing Address - Zip Code:96306-0001
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:NMRTU ATSUGI
Practice Address - Street 2:NAF ATSUGI, BLDG 21
Practice Address - City:FPO
Practice Address - State:AP
Practice Address - Zip Code:96306
Practice Address - Country:US
Practice Address - Phone:315-264-3959
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-16
Last Update Date:2023-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant