MS. DIANE MUNYON DIETTERLE NURSE PRACTITIONER NPI 1417125469

NPI Information

NPI: 1417125469
Provider Name: MS. DIANE MUNYON DIETTERLE, NURSE PRACTITIONER
Classification: Nurse Practitioner - 363LA2200X
Entity Type: Individual

Specialization: Adult Health

Address:
34012 EL CONTENTO DR
DANA POINT, CA
ZIP 92629
Phone: (949) 525-8795
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MS. Diane Munyon Dietterle, NURSE PRACTITIONER is an adult health nurse practitioner in Dana Point, CA. MS. Diane Munyon Dietterle, NURSE PRACTITIONER NPI is 1417125469. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

34012 EL CONTENTO DR
DANA POINT, CA
ZIP 92629-666
Phone: (949) 525-8795
Fax: (949) 489-0264

The enumeration date for this NPI number is 2/12/2008 and was last updated on 2/12/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	163W00000X	Registered Nurse		199901	CALIFORNIA	No
2	363LW0102X	Nurse Practitioner	Women's Health	11140	CALIFORNIA	No
3	363LA2200X	Nurse Practitioner	Adult Health	11140	CALIFORNIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	S95183	OTHER	OREGON	UPIN
2	108971	OTHER	OREGON	MEDICARE NUMBER: INACTIVE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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