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Individual
MS. DIANE MUNYON DIETTERLE
Active
Individual
MS. DIANE MUNYON DIETTERLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
199901
CA
363LA2200X
Adult Health Nurse Practitioner
Primary
11140
CA
363LW0102X
Women's Health Nurse Practitioner
11140
CA
Other
Enumeration date
02/12/2008
Last updated
02/12/2008
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