Bonita G. Dietrich in Peoria - Nurse Practitioner
Bonita G. Dietrich - NPI 1386734689
Bonita G. Dietrich is a Nurse Practitioner in Peoria, Illinois. Bonita G. Dietrich practices all healthcare services and medical treatments related to Nurse Practitioner. The NPI Number for Bonita G. Dietrich is 1386734689. The last update date is 2009-08-05.
Bonita G. Dietrich's current location address is 2900 N Knoxville Ave, Peoria, Illinois. You can contact this provider via phone number 3096883616 and fax number 3096873370. The mailing address for Bonita G. Dietrich is 2900 N Knoxville Ave, Peoria, Illinois. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Bonita G. Dietrich |
|---|---|
| Address | 2900 N Knoxville Ave, Peoria, Illinois |
| Phone Number | 3096883616 |
| Fax Number | 3096873370 |
| Sole Proprietor | N |
| Credentials | -- |
NPI Number Detail
| NPI Number | 1386734689 |
|---|---|
| Provider Enumeration Date | 2006-10-15 |
| Last Updated Date | 2009-08-05 |
Provider Mailing Address Detail
| Address | 2900 N Knoxville Ave |
|---|---|
| City | Peoria |
| State | Illinois (IL) |
| Post Code | 616031748 |
| Phone Number | 3096883616 |
| Fax Number | 3096873370 |
Provider's Primary Taxonomy Detail
| Speciality | Nurse Practitioner |
|---|---|
| Taxonomy | 363L00000X |
| Licence No | 041248649/20 |
|
Definition: (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certifi |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 809840019 | IL | MEDICARE INDIVIDUAL PTAN | |
| CA4079 | RR GROUP # |
Post Comment/ Review Below
What is the unique identifier code issued to Bonita G. Dietrich by the Centers for Medicare & Medicaid Services?
The Bonita G. Dietrich has been assigned the NPI (National Provider Identifier) 1386734689. This 10-digit code serves as a unique identification number for healthcare providers issued by the Centers for Medicare & Medicaid Services (CMS).
Could you provide the complete address where Bonita G. Dietrich is physically located?
The Bonita G. Dietrich is situated at the following address: 2900 N Knoxville Ave, Peoria, IL 616031748.
What is Bonita G. Dietrich's primary field of medical specialization, and what is the corresponding taxonomy classification code for this area of expertise?
The primary field of medical specialization for Bonita G. Dietrich is Nurse Practitioner, and the taxonomy classification code that categorizes this area of expertise is 363L00000X.
When did the Bonita G. Dietrich receive its 1386734689?
The Bonita G. Dietrich was issued its 1386734689 on 2006-10-15, which is the date when the organization was assigned this unique identifier.
When was the information regarding Bonita G. Dietrich, such as address, specialty, and other details, most recently verified or confirmed to be accurate?
The information pertaining to Bonita G. Dietrich, including its address, specialty, and other relevant details, was most recently verified or confirmed to be accurate on 2009-08-05.
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