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Bonita G. Dietrich
Nurse Practitioner in Peoria, Illinois
NPI 1386734689

Bonita G. Dietrich is a Nurse Practitioner based in Peoria, IL. Bonita G. Dietrich practices in Peoria, IL. The NPI Number for Bonita G. Dietrich is 1386734689 and holds a License No. 041248649/209000680 (Illinois).

The current practice location address for Bonita G. Dietrich is 2900 N Knoxville Ave, Peoria, IL and can be reached out via phone at 309-688-3616 and via fax at 309-687-3370.

Location: 2900 N Knoxville Ave, Peoria, IL, 61603-1748
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1386734689
Provider Name
Bonita G. Dietrich
Credential
Provider Entity Type
Individual
Gender
Female
Address
2900 N Knoxville Ave, Peoria, IL, 61603-1748
Phone Number
309-688-3616
Fax Number
309-687-3370
Provider Enumeration Date
10/15/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
809840019 01 IL MEDICARE INDIVIDUAL PTAN
CA4079 01 RR GROUP #
institution
Provider Business Practice Location Address Details
Address
2900 N Knoxville Ave
City
Peoria
State
Illinois
Zip
61603-1748
Phone Number
309-688-3616
Fax Number
309-687-3370
person
Provider Business Mailing Address Details
Address
2900 N Knoxville Ave
City
Peoria
State
Illinois
Zip
61603-1748
Phone Number
309-688-3616
Fax Number
309-687-3370
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
-
Taxonomy
363L00000X
License No.
041248649/209000680 (Illinois)
Definition
(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
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