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NPI 1922926187

NPI 1922926187 : HEIDI LYNNE DIEDIKER RN : PHOENIX, AZ

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General NPI Number Information
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    NPI Number           |    1922926187
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    Entity Type          |    Individual 
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    Provider Name        |    HEIDI LYNNE DIEDIKER RN
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    07/07/2026
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    Last Update Date     |    07/07/2026
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Provider Practice Location Address
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    Address Line         |    16440 S 32ND ST 
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    City                 |    PHOENIX
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    State                |    AZ
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    Zip                  |    85048-7807
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    Country              |    US
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    Telephone            |    605-929-0601
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    2736 E ROCKLEDGE RD 
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    City                 |    PHOENIX
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    State                |    AZ
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    Zip                  |    85048-8902
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    Country              |    US
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    Telephone            |    605-929-0601
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    Fax                  |    
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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        |    163WS0200X
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    Taxonomy Name        |    School Registered Nurse
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    License Number       |    322801
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    License Number State |    AZ
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