Doctor Name: | CARLA DIANNE DYER |
NPI Number: | 1033468939 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | DNP, APRN |
License Number: | 3007520 |
Business Practice Address: | 384 County Road 120 South South Point, OH - 456807807 |
Business Phone Number: | 7408942080 |
Business Fax Number: | 7408945406 |
Mailing Address: | Po Box 1595, ASHLAND |
State: | KY |
Postal Code: | 411051595 |
Phone Number: | 6064086200 |
Fax Number: | 6064086612 |
NPI Enumeration Date: | 09/06/2012 |
NPI Last Update Date: | 09/30/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 3007520 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | KY |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |