Provider Demographics
NPI:1124731518
Name:DIAZ-PATTERSON, QUIANNA JAZMYNE (PA-C)
Entity type:Individual
Prefix:
First Name:QUIANNA
Middle Name:JAZMYNE
Last Name:DIAZ-PATTERSON
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:86 HIGHLAND ST
Mailing Address - Street 2:
Mailing Address - City:GARDNER
Mailing Address - State:MA
Mailing Address - Zip Code:01440-1341
Mailing Address - Country:US
Mailing Address - Phone:603-438-0573
Mailing Address - Fax:
Practice Address - Street 1:86 HIGHLAND ST
Practice Address - Street 2:
Practice Address - City:GARDNER
Practice Address - State:MA
Practice Address - Zip Code:01440-1341
Practice Address - Country:US
Practice Address - Phone:603-438-0573
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-30
Last Update Date:2022-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant