Individual
MRS. ASHLEE NICOLE DIRADO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHYSICIAN ASSISTANT
Contact information
Practice address
311 W 24TH ST STE 101, ERIE, PA 16502
(814) 452-4214
Mailing address
311 W 24TH ST STE 101, ERIE, PA 16502-2668
(814) 452-4214
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
MA059630
PA
363AM0700X
Medical Physician Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04013796
—
NY
Enumeration date
07/03/2014
Last updated
10/01/2020
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