KYLE PHILLIP DIETRICH PA STUDENT NPI 1932661352

NPI Information

  • NPI: 1932661352
  • Provider Name: KYLE PHILLIP DIETRICH, PA STUDENT
  • Classification: Student in an Organized Health Care Education/Training Program - 390200000X
  • Entity Type: Individual
  • Address: 921 S 8TH AVE STOP 8253
    POCATELLO, ID
    ZIP 83209
  • Phone: (208) 282-4726

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NPI Details

Kyle Phillip Dietrich, PA STUDENT is a student in an organized health care education training program in Pocatello, ID. The provider is an individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. Kyle Phillip Dietrich, PA STUDENT NPI is 1932661352. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

921 S 8TH AVE STOP 8253
POCATELLO, ID
ZIP 83209-002
Phone: (208) 282-4726

The enumeration date for this NPI number is 4/3/2019 and was last updated on 5/5/2024.

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
1225700000XMassage TherapistLMT-LMT-LIC-15881MONTANANo
2390200000XStudent in an Organized Health Care Education/Training ProgramYes

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: 3/30/2025

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