Healthcare Provider Details

I. General information

NPI: 1457683864
Provider Name (Legal Business Name): DIANE ALAYNE INCH PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/10/2010
Last Update Date: 07/21/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

202 ISLAND DR SUITE 1
FORT PIERRE SD
57532-7302
US

IV. Provider business mailing address

202 ISLAND DR SUITE 1
FORT PIERRE SD
57532-7302
US

V. Phone/Fax

Practice location:
  • Phone: 605-223-2228
  • Fax:
Mailing address:
  • Phone: 605-223-2228
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number0731
License Number StateSD

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: