Healthcare Provider Details

I. General information

NPI: 1316169782
Provider Name (Legal Business Name): VICKI LYNN DIHLE PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/03/2007
Last Update Date: 05/28/2026
Certification Date: 05/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3386 BLUE GRASS CIR
CASTLE ROCK CO
80109-8450
US

IV. Provider business mailing address

3386 BLUE GRASS CIR
CASTLE ROCK CO
80109-8450
US

V. Phone/Fax

Practice location:
  • Phone: 303-917-5211
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number1874
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: