Individual
ELIZABETH GRAY DIETZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
C.P.N.P.
Contact information
Practice address
14400 SOMMERVILLE CT, MIDLOTHIAN, VA 23113-6835
(804) 379-5437
Mailing address
14400 SOMMERVILLE CT, MIDLOTHIAN, VA 23113-6835
(804) 737-9543
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
0024168311
VA
Other
Enumeration date
07/08/2009
Last updated
02/09/2021
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