Physician Assistant, Medical
DIANE TACKIE PA-C
Identity confirmed via CMS NPPES · September 30, 2026 · A directory match is not a coverage approval.
Is this your practice? This listing was imported from public provider identity data (CMS NPPES) and has not yet been claimed. Claim this listing to confirm the practice details. Plan acceptance stays unpublished until the practice reports it.
Public record
NPI 1871894808 · enumerated 2010-11-08 · record updated 2026-03-19. Source: CMS NPPES. A listing is not a TRICARE network approval.
NPPES recordGoogle Maps Apple Maps OpenStreetMap
Other names: DIANE TACKIE GRANILLO
Addresses and phones
- Mailing address 1395 PICCARD DR STE 200, ROCKVILLE, MD, 20850-4348 (202) 951-7942 Fax (202) 971-1991 Google Maps Apple Maps OpenStreetMap
- Practice location 1395 PICCARD DR STE 200, ROCKVILLE, MD, 20850-4348 (202) 951-7942 Fax (202) 971-1991 Google Maps Apple Maps OpenStreetMap
Specialties
- Physician Assistant 363A00000X · License PA031403 DC
- Physician Assistant, Medical 363AM0700X · Primary · License C04246 MD
In this directory
Locations and evidence
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Practice location
ROCKVILLE, MD, 208504348
Accepting new patientsNot reportedCMS NPPES · September 30, 2026
Plan acceptance
- No published plan acceptance yet. Confirm directly with the practice, or claim this listing if it's yours.