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NPI Code Detail

MEDICARE: CHRISTINE DIEDERICH NP

MEDICARE: CHRISTINE DIEDERICH NP
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
1363LF0000XFamily Nurse PractitionerR128637-3MN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1447212345
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHRISTINE DIEDERICH NP
Provider Business Mailing Address
First Line : 100 2ND ST S
Second Line :
City : SARTELL
State : MN
Zip : 56377-1977
Country : US
Telephone Number : 320-251-2600
Fax Number : 320-251-4763
Provider Business Practice Location Address
First Line : 100 2ND ST S
Second Line :
City : SARTELL
State : MN
Zip : 56377-1977
Country : US
Telephone Number : 320-251-2600
Fax Number : 320-251-4763
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/05/2006
Last Update Date : 01/31/2017

Similar Medicare Providers

1043217706 — MR. MICHAEL JUDE MILBAUER DC
Practice Location Address:
100 2ND ST S
SARTELL, MN
56377-1977
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1982601647 — MR. MARK RANDY HALSTROM MD
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100 2ND ST S
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1972500635 — MISS MELISSA ANN MORTENSEN MPT
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1235136995 — MR. RYAN JAMES GRANROTH DC
Practice Location Address:
100 2ND ST S
SARTELL, MN
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1639275605 — MR. DEAN ALAN STULZ PA
Practice Location Address:
100 SOUTH 2ND STREET
SARTELL, MN
56377-1977
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1457452666 — DR. MATTHEW G. ROSSITER D.C.
Practice Location Address:
100 2ND ST S
SARTELL, MN
56377-1977
Practice Phone: 320-251-2600
Practice Fax: 320-251-4763

Directions to “ CHRISTINE DIEDERICH NP” Practice Location

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