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Individual

NATHALIE K DIETHRICH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PMHNP

Contact information

Practice address
151 N MAIN ST, DECATUR, IL 62523-1206
(217) 362-6262
(217) 362-6290
Mailing address
151 N MAIN ST, DECATUR, IL 62523-1206
(217) 362-6262
(217) 362-6290

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
209.014716
IL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
277001744
IL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
377001689
IL

Other

Enumeration date
09/12/2016
Last updated
09/30/2025
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