Dietsch, Carol M.

Dietsch, Carol M. is an individual health care provider with primary practice located at 1441 W Central Park Ave , Davenport IA 52804-1707. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health, Nursing Service Providers / Psychiatric/Mental Health. Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health is her primary health care specialty. Dietsch, Carol M. can be contacted via phone (563) 383-1900.

Contact Information

Primary practice address
1441 W Central Park Ave Davenport IA 52804-1707
Phone: (563) 383-1900
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X G034112 Iowa
Nursing Service Providers / Psychiatric/Mental Health 163WP0808X 034112 Iowa

Profile Details

NPI number 1821137548
LBN Legal business name Dietsch, Carol M.
Credentials ARNP
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 6th, 2007
Last updated May 22nd, 2008 - about 16 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1821137548 NPPES
Iowa MEDICAID 420716337

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