Dietrich, Jay Martin

Dietrich, Jay Martin is an individual health care provider with primary practice located at 2200 E Washington St , Bloomington IL 61701-4364. He recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, Nursing Service Providers / Registered Nurse. Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner is his primary health care specialty. Dietrich, Jay Martin can be contacted via phone (309) 662-3311.

Contact Information

Primary practice address
2200 E Washington St Bloomington IL 61701-4364
Phone: (309) 662-3311
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 209021931 Illinois
Nursing Service Providers / Registered Nurse 163W00000X 041446858 Illinois

Profile Details

NPI number 1225629447
LBN Legal business name Dietrich, Jay Martin
Credentials APN, NP-C
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 30th, 2021
Last updated Jan 30th, 2021 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

Request for update

Popular Providers