Individual
KIMBERLY KAY DIETRICH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
417 S WHITLOCK ST, BREMEN, IN 46506-1626
(574) 546-0330
Mailing address
417 S WHITLOCK ST, BREMEN, IN 46506-1626
(574) 546-0330
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
71010955A
IN
Other
Enumeration date
02/26/2021
Last updated
12/27/2024
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