Individual
MISS DIANA LEE ANDERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
300 WANDA ST, MARIETTA, OK 73448-1200
(580) 276-3347
(580) 276-4795
Mailing address
PO BOX 776084, CHICAGO, IL 60677-6084
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
36138
MT
363A00000X
Physician Assistant
Primary
5595
OK
363A00000X
Physician Assistant
WY445
WY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
07/17/2008
Last updated
01/09/2026
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