National Provider Identifier Database

TRACY M DIETZ, FNP – NPI #1477941938
Family


Contact Information

TRACY M DIETZ, FNP
3523 WICKENHAUSER AVE
ALTON, IL62002
Phone: 618-465-8887
Fax:
Website:
Specialty Taxonomy Code
* Family 363LF0000X

* Indicates primary specialty

NPI Profile & details for TRACY M DIETZ

NPI Number 1477941938
Credentials FNP (Family Nurse Practitioner)
Entity Individual
Enumeration date 01/06/2015
Last updated 09/28/2015 - About 11 years ago
Sole proprietor1 No
Identifiers
  • IL License #: 209.011378
Hospital affiliation n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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