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NPI Code Detail

MEDICARE: SAMANTHA DIETZ

MEDICARE: SAMANTHA DIETZ
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
1363LP0808XPsychiatric/Mental Health Nurse Practitioner532129OH

General Provider Information

NPI Number : 1508664178
Entity Type Code : Individual
Provider Name (Legal Business Name) : SAMANTHA DIETZ
Provider Business Mailing Address
First Line : 801 W MINERAL AVE STE 101
Second Line :
City : LITTLETON
State : CO
Zip : 80120-5663
Country : US
Telephone Number : 720-466-1932
Fax Number : 720-802-7462
Provider Business Practice Location Address
First Line : 801 W MINERAL AVE STE 101
Second Line :
City : LITTLETON
State : CO
Zip : 80120-5663
Country : US
Telephone Number : 720-466-1932
Fax Number : 720-802-7462
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/07/2025
Last Update Date : 12/30/2025

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Directions to “ SAMANTHA DIETZ ” Practice Location

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