Individual
GLORIA X DIENERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
120 E BEAUREGARD AVE, SAN ANGELO, TX 76903-5919
(325) 658-1511
(325) 481-2165
Mailing address
PO BOX 22000, SAN ANGELO, TX 76902-7200
(325) 658-1511
(325) 481-2165
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
640822
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
F0911123
CERTIFICATION
TX
Enumeration date
10/10/2011
Last updated
10/10/2011
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