Individual
JENNIFER ANN DIEDERICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
200 BUNKER HILL DR, AITKIN, MN 56431-1865
(218) 927-2157
(218) 927-5319
Mailing address
200 BUNKER HILL DR, AITKIN, MN 56431-1865
(218) 927-2157
(218) 927-5319
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
8227
MN
Other
Enumeration date
08/09/2021
Last updated
08/09/2021
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