Individual
MANDI DIEDERICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
107 S 8TH ST, MARYSVILLE, KS 66508-1831
(785) 619-6078
Mailing address
404 S HANOVER ST, HANOVER, KS 66945-8862
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
01/07/2025
Last updated
05/31/2026
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