Individual
RENEE L DIETRICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1110 10TH AVE STE 101, MENOMINEE, MI 49858-3058
(906) 863-1286
Mailing address
325 E H ST, IRON MOUNTAIN, MI 49801-4760
(906) 774-3300
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
088583
IA
363LF0000X
Family Nurse Practitioner
Primary
7315-33
WI
Other
Enumeration date
08/04/2011
Last updated
04/17/2020
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