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General NPI Number Information
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NPI Number | 1184910416
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Entity Type | Individual
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Provider Name | KIRSTI ANNA DIEHL D.P.M.
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Gender | Female
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Dates
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Enumeration Date | 06/24/2011
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Last Update Date | 02/18/2025
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Provider Practice Location Address
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Address Line | 110 LIBERTY ST
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City | BROCKTON
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State | MA
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Zip | 02301-5674
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Country | US
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Telephone | 508-941-7772
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Fax | 508-559-7035
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Provider Business Mailing Address
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Address Line | 110 LIBERTY ST
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City | BROCKTON
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State | MA
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Zip | 02301-5674
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Country | US
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Telephone | 508-941-7772
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Fax | 508-559-7035
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | DPM00343
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License Number State | RI
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Taxonomy #2
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | 0345
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License Number State | NH
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Taxonomy #3
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | PDF7272
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License Number State | MA
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