Individual provider · Type 1 NPI

Bonita G. Dietrich

Nurse Practitioner · Peoria, IL

NPI number 1386734689 Active

Practice location

2900 N Knoxville Ave
Peoria, IL 61603-1748

Fax (309) 687-3370

Specialties and licenses

Taxonomy	Code	License
Nurse Practitioner Primary	363L00000X	041248649/209000680 (IL)

Nurse Practitioner: (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance wit…

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About NPI 1386734689

Bonita G. Dietrich's National Provider Identifier is 1386734689, issued on Oct 15, 2006. The primary taxonomy on file is Nurse Practitioner (363L00000X), and the practice location is in Peoria, IL. The record was last updated on Aug 5, 2009.