CLORISSA DIEDRICH CPNP-PC NPI 1508410747

NPI Information

NPI: 1508410747
Provider Name: CLORISSA DIEDRICH, CPNP-PC
Classification: Nurse Practitioner - 363LP0200X
Entity Type: Individual

Specialization: Pediatrics

Address:
829 N CENTER AVE STE 130
GAYLORD, MI
ZIP 49735
Phone: (989) 731-7930
Get Directions

Clorissa Diedrich, CPNP-PC is a pediatrics nurse practitioner in Gaylord, MI. Clorissa Diedrich, CPNP-PC NPI is 1508410747. 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:

829 N CENTER AVE STE 130
GAYLORD, MI
ZIP 49735-684
Phone: (989) 731-7930
Fax: (989) 731-7948

The enumeration date for this NPI number is 7/25/2019 and was last updated on 8/8/2019.

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	363LP0200X	Nurse Practitioner	Pediatrics	4704321562	MICHIGAN	Yes

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: 5/5/2024

NPI Synchronization or Removal

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