Provider Demographics
NPI:1649365024
Name:DIEHL, GRACE A (PA-C)
Entity type:Individual
Prefix:
First Name:GRACE
Middle Name:A
Last Name:DIEHL
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 1549
Mailing Address - Street 2:
Mailing Address - City:BUTLER
Mailing Address - State:PA
Mailing Address - Zip Code:16003-1549
Mailing Address - Country:US
Mailing Address - Phone:724-284-4460
Mailing Address - Fax:724-284-4144
Practice Address - Street 1:432 HILLCREST AVE
Practice Address - Street 2:SUITE 3
Practice Address - City:GROVE CITY
Practice Address - State:PA
Practice Address - Zip Code:16127-1730
Practice Address - Country:US
Practice Address - Phone:724-615-9193
Practice Address - Fax:724-458-6689
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2016-03-29
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAMA052655363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant