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Individual

KYLE RICHARD DIETZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
5300 E CHERRY CREEK SOUTH DR APT 622, DENVER, CO 80246-2737
(901) 461-2690
Mailing address
5300 E CHERRY CREEK SOUTH DR APT 622, DENVER, CO 80246-2737
(901) 461-2690

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
1644505
CO
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
0999897
CO

Other

Enumeration date
10/23/2020
Last updated
07/05/2024
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