Jay Martin Dietrich, APN, NP-C
NPI #1225629447 in Bloomington, Illinois
Provider Information
- NPI Number
- 1225629447
- Entity Type
- Individual
- Name
- Jay Martin Dietrich, APN, NP-C
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Nurse Practitioner
- Credential
- APN, NP-C
- Enumeration Date
- Jan 30, 2021
- Last Updated
- Jan 30, 2021
Practice Location
- Address
- 2200 E WASHINGTON ST
- City
- Bloomington
- State
- Illinois
- ZIP Code
- 61701-4364
- Phone
- (309) 662-3311
Specialties & Taxonomy Codes
| Specialty |
|---|
| Nurse Practitioner |
| Registered Nurse |
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