Individual
ASHLEY L DIEDRICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AA
Contact information
Practice address
744 S WEBSTER AVE, GREEN BAY, WI 54301-3505
(920) 433-3605
(920) 433-3589
Mailing address
PO BOX 22487, GREEN BAY, WI 54305-2487
(920) 445-7222
(920) 445-7289
Taxonomy
Speciality
Code
Description
License number
State
367H00000X
Anesthesiologist Assistant
Primary
26
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
748
NATIONAL COMMISSION CERTIFICATION ANESTHESIA ASSISTANTS
—
Enumeration date
09/12/2006
Last updated
08/31/2020
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