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Individual

DEANNA NICOLE DIETRICH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
501 HANNIBAL ST, FULTON, NY 13069-1015
(315) 887-1059
Mailing address
501 HANNIBAL ST, FULTON, NY 13069-1015
(315) 887-1059

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
PA9116592
FL
363A00000X
Physician Assistant
031818-01
NY
363A00000X
Physician Assistant
Primary
PA.0007617
CO
363A00000X
Physician Assistant
PA9116592
FL

Other

Enumeration date
11/15/2022
Last updated
08/15/2024
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