Individual
MS. KATHLEEN DIANA DEBIAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2550 N THUNDERBIRD CIRCLE, STE. 303, MESA, AZ 85215
(480) 776-1603
Mailing address
2550 N THUNDERBIRD CIRCLE, STE. 303, MESA, AZ 85215
(480) 776-1603
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
842-023
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
78781736
—
NM
05
—
862202
—
AZ
Enumeration date
11/01/2006
Last updated
09/04/2012
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