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Individual

JOHN WARNER DIETRICH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
FNP

Contact information

Practice address
330 NE BARRY RD, KANSAS CITY, MO 64155-2724
(785) 969-2304
Mailing address
330 NE BARRY RD, KANSAS CITY, MO 64155-2724
(785) 969-2304

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2011034132
MO
363LF0000X
Family Nurse Practitioner
53-75495-082
KS

Other

Enumeration date
09/28/2011
Last updated
10/13/2017
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