Individual
MS. ELIZABETH ANNE DIEDRICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
F.N.P.
Contact information
Practice address
9165 W THUNDERBIRD RD,, STE 100, PEORIA, AZ 85381-4669
(623) 583-6554
(623) 523-6581
Mailing address
13640 N PLAZA DEL RIO BLVD, PEORIA, AZ 85381-4846
(623) 876-3800
(623) 876-6965
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP3288
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
449581
—
AZ
01
—
AP3288
AZ MEDICAL LICENSE
AZ
Enumeration date
08/04/2009
Last updated
11/20/2009
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