Individual
SUSAN PATRICIA DIERKES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
811 MORROW ST, SUITE 208, DRESDEN, TN 38225-1846
(731) 364-3353
(731) 364-3373
Mailing address
811 MORROW ST, SUITE 208, DRESDEN, TN 38225-1846
(731) 364-3353
(731) 364-3373
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1493
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
36651031
—
TN
01
—
4180537
BCBS
TN
01
—
43637
TLC
TN
Enumeration date
06/15/2007
Last updated
10/09/2008
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