MR. JERE WAYNE DITTRICH NP NPI 1700287562

NPI Information

NPI: 1700287562
Provider Name: MR. JERE WAYNE DITTRICH, NP
Classification: Registered Nurse - 163WP0809X
Entity Type: Individual

Specialization: Psychiatric/Mental Health, Adult

Address:
100 SOUTH ST
SOUTHBRIDGE, MA
ZIP 01550
Phone: (774) 452-2006
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MR. Jere Wayne Dittrich, NP is a psychiatric/mental health and adult registered nurse in Southbridge, MA. MR. Jere Wayne Dittrich, NP NPI is 1700287562. 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:

100 SOUTH ST
SOUTHBRIDGE, MA
ZIP 01550-051
Phone: (774) 452-2006
Fax: (508) 909-7715

The enumeration date for this NPI number is 9/11/2014 and was last updated on 9/11/2014.

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	163WP0809X	Registered Nurse	Psychiatric/Mental Health, Adult	RN199369	MASSACHUSETTS	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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