LESLIE A. DIETERICH (NPI# 1417030701) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417030701 |
| Entity Type | Individual |
| Full Name | LESLIE A. DIETERICH |
| Credential | CNP |
| Practice Address |
399 E Main St Newark OH 43055-6516 |
| Practice Telephone | 7403481840 |
| Practice Fax Number | 7403481841 |
| Mailing Telephone | 7403481840 |
| Mailing Fax Number | 7403481841 |
| Enumeration Date | 2006-10-23 |
| Last Update Date | 2014-02-25 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
COA-02929-NP | OH | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
399 E MAIN ST |
| City | NEWARK |
| State | OH |
| Zip Code | 43055-6516 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144228131 | Katrina M Timson | Family Medicine | 399 E Main St, Newark, OH 43055-6516 | 2005-07-13 |
| 1700050309 | Brian Todd Klima | Pediatrics | 399 E Main St, Newark, OH 43055-6516 | 2008-04-15 |
| 1669547824 | Licking Memorial Professional Corp. | Pediatrics | 399 E Main St, Newark, OH 43055-6516 | 2006-11-22 |
| 1073531729 | Licking Memorial Professional Corp | Family Medicine | 399 E Main St, Newark, OH 43055-6516 | 2006-07-18 |
| 1851399620 | Diane Lemay | Pediatrics | 399 E Main St, Newark, OH 43055-6516 | 2005-07-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770125585 | Jessica Danielle Dunkle | Case Manager/Care Coordinator | 15 N 3rd Street Suite 300, Newark, OH 43055 | 2019-10-14 |
| 1558910331 | Diana Cleland | Home Health Aide | 25 Western Rd, Apartment A, Newark, OH 43055 | 2019-09-05 |
| 1912424789 | Sandra Lou Fraley | Community/Behavioral Health | 15 North 3rd Street, Suite 300, Newark, OH 43055 | 2017-08-23 |
| 1215450911 | Caitlyn Thella Smith Elkins | Social Worker | 15 N. 3rd St., Newark, OH 43055 | 2017-07-25 |
| 1992227888 | Sierra Elizabeth Donley | Student in an Organized Health Care Education/Training Program | 140 W Church St, Newark, OH 43055 | 2017-07-12 |
| 1386170587 | Patricia Louise Fischer | Pharmacist | 1155 North 21rst Street, Newark, OH 43055 | 2017-05-08 |
| 1689120958 | Bebout Services, LLC | Home Health | 1325 Dayton Road Ne, Newark, OH 43055 | 2016-08-28 |
| 1750834594 | Laura Smith | Registered Nurse | 1445 West Main Street, Suite B, Newark, OH 43055 | 2016-07-28 |
| 1164807277 | Frank Kobe | Psychologist | 116 N. 21st Street, Newark, OH 43055 | 2015-07-30 |
| 1770975898 | Gentle Foot Care, Inc | Podiatrist | 1271 W Main Street, Bldg 1, Newark, OH 43055 | 2015-02-26 |
| Find all providers in zip 43055 | ||||
| Taxonomy Code | 363LP0200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Pediatrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700432739 | Jessica Lynn Pajak | Nurse Practitioner | 875 Aaa Blvd Ste C, Newark, DE 19713-3624 | 2019-08-15 |
| 1366850547 | Amber Lewis | Nurse Practitioner | 4735 Ogletown-stanton Rd Map 2 Suite 1116, Newark, DE 19713 | 2014-07-31 |
| 1114124203 | Nancy C Whelan | Nurse Practitioner | 200 Lyons Ave, Building L-5 Pediatric Gastroenterology, Newark, NJ 07112-2026 | 2007-07-02 |
| 1851598569 | Cathleen Cahill | Nurse Practitioner | 182 Lyons Ave, Newark, NJ 07112-2026 | 2007-06-27 |
| 1497877260 | Elizabeth O'rourke Sweet | Nurse Practitioner | 501 Ogletown Rd, Hudson State Service Center, Child Health Clinic, Newark, DE 19711-5403 | 2007-04-04 |
| 1164569588 | Martha Coppage-lawrence | Nurse Practitioner | 2575 Glasgow Ave, Newark, DE 19702-4747 | 2007-02-01 |
| 1245216225 | Christine Louise Rudkin | Nurse Practitioner | University of Delaware Student Health Service, Laurel Hall, Newark, DE 19716-8108 | 2005-12-21 |
| 1013579598 | Debra J Brouwer | Nurse Practitioner | 201 Lyons Ave, Newark, NJ 07112-2027 | 2019-07-03 |
| 1407324403 | Bethany Sigley | Nurse Practitioner | 201 Lyons Ave, Newark, NJ 07112-2027 | 2018-11-07 |
| 1679050025 | Adrian Leibas | Nurse Practitioner | 1671 W Main St, Newark, OH 43055-1345 | 2018-07-27 |
| Find all providers in NEWARK | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.