Individual
KATHRYN RUDOLPH DIEKHOFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
11141 PARKVIEW PLAZA DR STE 305, FORT WAYNE, IN 46845-1715
(260) 266-8900
(260) 266-8935
Mailing address
11109 PARKVIEW PLAZA DR # 117, FORT WAYNE, IN 46845-1701
Taxonomy
Speciality
Code
Description
License number
State
163WP2201X
Ambulatory Care Registered Nurse
28228993A
IN
363L00000X
Nurse Practitioner
Primary
71013497A
IN
Other
Enumeration date
12/12/2022
Last updated
08/30/2023
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