Individual
MS. JANENE MARY DIEKMANN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ANP-BC
Contact information
Practice address
5520 STATE ROAD 64, BRADENTON CBOC, BRADENTON, FL 34208
(573) 265-0448
(573) 265-0449
Mailing address
620 N JEFFERSON ST, SAINT JAMES, MO 65559-1926
(573) 265-0448
(573) 265-0449
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
107141
IA
363LA2200X
Adult Health Nurse Practitioner
Primary
137819
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1407819477
—
FL
Enumeration date
04/10/2006
Last updated
04/10/2020
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