Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
SHANNON LEE RUTH DIEFFENDERFER
Active Sole ProprietorSHANNON LEE RUTH DIEFFENDERFER is a Physician Assistant healthcare provider located in ANCHORAGE, Alaska. NPI 1861048530 is currently active in the NPPES registry. Verify at CMS.
Physician Assistant · ANCHORAGE, AK
Registration Details
- NPI Number
- 1861048530
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Aug 17, 2019 (6.9882492320133 yrs)
- Last Updated
- Jun 6, 2022
- Licenses
-
10117 (GA)172156 (AK)
- Sole Proprietor
- Yes
Practice Information
- Address
-
4100 LAKE OTIS PKWY STE 108ANCHORAGE, AK, 995085230Browse AK providers · Browse ZIP 99508
- Phone
- 9075633145
- Fax
- 9075613967
- Primary Specialty
-
Physician Assistant
363A00000X
- Additional Specialty
- Student (Health Education/Training)
- Additional Specialty
- Physician Assistant
Other Physician Assistant Providers in ANCHORAGE, AK
| Name | Credential | NPI |
|---|---|---|
| TERRI ALTHEA BERNDT | PA-C | 1568458222 |
| OLEGARIO CARRILLO | PA-C | 1417946039 |
| CARLENE KAY BODEN | P.A. | 1235128349 |
| MR. TIMOTHY G HARRELSON JR. | PA | 1952391559 |
| MR. DAN RAYMOND CALDERON | PA-C | 1639153109 |
| TIMOTHY A MORGAN | PA C | 1578540159 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.