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Individual

DIANA B MORELAND

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
405 W JACKSON ST, CARBONDALE, IL 62901-1462
(618) 549-0721
(618) 457-0469
Mailing address
1239 E MAIN ST, CARBONDALE, IL 62901-3175
(618) 457-5200

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085000984
IL
363AM0700X
Medical Physician Assistant
085-000984
IL

Other

Enumeration date
06/30/2006
Last updated
03/07/2023
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