Doctor Name: | MRS. RETA JOYCE DIEDRICH |
NPI Number: | 1699951590 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | RN |
License Number: | R059996-4 |
Business Practice Address: | 119 4th St. Sandstone, MN - 55072 |
Business Phone Number: | 3202455362 |
Business Fax Number: | |
Mailing Address: | 606 Power Ave S, P.o. Box 684 HINCKLEY |
State: | MN |
Postal Code: | 550379366 |
Phone Number: | 3203846039 |
Fax Number: | |
NPI Enumeration Date: | 01/10/2008 |
NPI Last Update Date: | 01/10/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 163WC0400X |
License Number: | R059996-4 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MN |
Taxonomy Type: | Nursing Service Providers |
Taxonomy Classification: | Registered Nurse |
Taxonomy Specialization: | Case Management |
Taxonomy Definition: |