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Individual

JENNY DIETZ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
602 8TH ST SW, ALTOONA, IA 50009-2301
(515) 414-1830
Mailing address
11809 241ST AVE, HARMONY, MN 55939-6515
(260) 265-0799

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
233383
AZ
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
G155693
IA

Other

Enumeration date
07/24/2019
Last updated
05/04/2024
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