Wenzke, Gillian Diederich

Wenzke, Gillian Diederich is an sole proprietor health care provider with primary practice located at 500 Lincoln Park Blvd Suite 100, Dayton OH 45429-3492. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as her primary health care specialty. Wenzke, Gillian Diederich can be contacted via phone (937) 222-3118.

Contact Information

Primary practice address
500 Lincoln Park Blvd Suite 100 Dayton OH 45429-3492
Phone: (937) 222-3118
Fax: (937) 222-1436
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X CNP.019493 Ohio

Profile Details

NPI number 1669925673
LBN Legal business name Wenzke, Gillian Diederich
Credentials AG-ACNP
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 26th, 2016
Last updated Nov 8th, 2024 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1669925673 NPPES
Ohio MEDICAID PENDING

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