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Individual

DIANA ANN MCCANN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
85 N GRAND AVE, FORT THOMAS, KY 41075-4027
(859) 572-3618
Mailing address
25203 TRANQUILITY CT, WEST HARRISON, IN 47060-7634
(812) 577-7805

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
10004413A
IN
363A00000X
Physician Assistant
TC186
KY
363AM0700X
Medical Physician Assistant
Primary
50.008332RX
OH

Other

Enumeration date
08/21/2023
Last updated
07/30/2024
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