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NPI Code Detail

MEDICARE: MCKENNA JUDITH DEIBLE

MEDICARE: MCKENNA JUDITH DEIBLE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician Assistant

General Provider Information

NPI Number : 1942165527
Entity Type Code : Individual
Provider Name (Legal Business Name) : MCKENNA JUDITH DEIBLE
Provider Business Mailing Address
First Line : 122 MASON LN
Second Line :
City : KNOX
State : PA
Zip : 16232-5916
Country : US
Telephone Number : 814-221-5806
Fax Number :
Provider Business Practice Location Address
First Line : 1972 CLARK AVE
Second Line :
City : ALLIANCE
State : OH
Zip : 44601-3929
Country : US
Telephone Number : 800-992-6682
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/17/2025
Last Update Date : 12/17/2025

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Directions to “ MCKENNA JUDITH DEIBLE ” Practice Location

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