Individual
JILL DENISE DIERKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
9947 W HAPPY VALLEY RD STE 104, PEORIA, AZ 85383-1222
(623) 434-5748
(623) 566-9665
Mailing address
2405 ROCK ISLAND RD, OELWEIN, IA 50662-3102
(319) 283-2651
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
TAP10109
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
N/A
N/A
AZ
Enumeration date
05/12/2017
Last updated
12/29/2020
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