Individual provider · Type 1 NPI

Jay Martin Dietrich, APN, NP-C

Family Nurse Practitioner · Normal, IL

NPI number 1225629447 Active

Practice location

2200 Fort Jesse Rd Ste 110
Normal, IL 61761-6286

Fax (309) 451-1354

Specialties and licenses

TaxonomyCodeLicense
Family Nurse Practitioner Primary 363LF0000X209021931 (IL)
Nurse Practitioner 363L00000X209021931 (IL)

Family Nurse Practitioner: Definition to come...

10 other providers at this address

Other family nurse practitioner providers in Normal

See all in Normal →

About NPI 1225629447

Jay Martin Dietrich, APN, NP-C's National Provider Identifier is 1225629447, issued on Jan 30, 2021. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in Normal, IL. The record was last updated on May 29, 2026.