Individual
JENNIFER DIETRICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
1504 SANTA ROSA RD RM 114, HENRICO, VA 23229-5109
(804) 210-3103
(804) 210-3104
Mailing address
28 ABBY RD, PALMYRA, VA 22963-2085
(434) 589-2278
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
0024172207
VA
Other
Enumeration date
12/09/2014
Last updated
06/05/2024
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