Brenna Dieterle, is a
Speech-language Pathologist based in Crystal, North Dakota. Brenna Dieterle is licensed to practice in North Dakota (license number 2622) and her current practice location is
4013 Euclid Ave, Crystal, North Dakota. She can be reached at her office (for appointments etc.) via phone at
(701) 657-2163.
NPI number for Brenna Dieterle is 1093541609 and her current mailing address is Po Box 129, Crystal, North Dakota. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1093541609.
Healthcare Provider's Profile
| Full Name | Brenna Dieterle |
|---|
| Gender | Female |
|---|
| Speciality | Speech-language Pathologist |
|---|
| Location | 4013 Euclid Ave, Crystal, North Dakota |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1093541609
- Provider Enumeration Date: 09/10/2024
- Last Update Date: 09/10/2024
Medical Identifiers
Medical identifiers for Brenna Dieterle such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1093541609 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 235Z00000X | Speech-language Pathologist | 2622 (North Dakota) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Brenna Dieterle is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Brenna Dieterle,
Po Box 129,
Crystal, ND 58222-0129
Ph: () - | Brenna Dieterle,
4013 Euclid Ave,
Crystal, ND 58222-4014
Ph: (701) 657-2163 |
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