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DANETTE LEE DIETHERT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PMHNP

Contact information

Practice address
523 N 3RD ST, BRAINERD, MN 56401-3054
(218) 829-2861
(218) 828-3130
Mailing address
523 N 3RD ST, BRAINERD, MN 56401-3054
(218) 829-2861

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
R-104601-4
MN

Other

Enumeration date
08/25/2014
Last updated
01/07/2016
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