Individual
SHELBI DIEZEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
479 VAN CAMP SQ, GREENWOOD, IN 46143-1616
(317) 694-6089
Mailing address
479 VAN CAMP SQ, GREENWOOD, IN 46143-1616
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10003422A
IN
Other
Enumeration date
10/14/2021
Last updated
12/12/2022
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