Renee L Dietrich, | |
1110 10th Ave Ste 101, Menominee, MI 49858-3058 | |
(906) 863-1286 | |
Not Available |
Full Name | Renee L Dietrich |
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Gender | Female |
Speciality | Nurse Practitioner - Family |
Location | 1110 10th Ave Ste 101, Menominee, Michigan |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1821377177 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
363LF0000X | Nurse Practitioner - Family | 088583 (Iowa) | Secondary |
363LF0000X | Nurse Practitioner - Family | 7315-33 (Wisconsin) | Primary |
Entity Name | Signify Health Medical Associates Pllc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1750845863 PECOS PAC ID: 2163764424 Enrollment ID: O20191217001453 |
Mailing Address | Practice Location Address |
---|---|
Renee L Dietrich, 325 E H St, Iron Mountain, MI 49801-4760 Ph: (906) 774-3300 | Renee L Dietrich, 1110 10th Ave Ste 101, Menominee, MI 49858-3058 Ph: (906) 863-1286 |
Mrs. Susan Bonnie Pulkowski, APN Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 305 Henes Park Dr, Menominee, MI 49858 Phone: 815-543-3352 | |
Debra J Hilling, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1110 10th Ave, Menominee, MI 49858 Phone: 906-290-5000 Fax: 906-863-2408 | |
April M Jensen, NP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 2408 10th St, Menominee, MI 49858 Phone: 906-863-4100 Fax: 906-863-4101 | |
Emily J Boettcher, NP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 2408 10th St, Menominee, MI 49858 Phone: 906-863-4100 |