Danette Lee Diethert, PMHNP
Nurse Practitioner, Psych/Mental Health in Brainerd, MN. Individual provider (NPI-1).
NPI number1083014385
StatusActive
Last updated in NPPESJan 7, 2016
Details
- NPI
- 1083014385
- Entity type
- Individual (NPI-1)
- Name
- Danette Lee Diethert
- Credential
- PMHNP
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Aug 25, 2014
- Last updated
- Jan 7, 2016
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - NURSE PRACTITIONER
- Can order and refer
- Part B Yes · DME Yes · Home health Yes · Power mobility Yes · Hospice No
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LP0808X | Nurse Practitioner, Psych/Mental Health | R-104601-4 | MN | Yes |
Other names
- Danette Lee Christianson (Former Name)
Practice location
523 N 3rd StBrainerd, MN 56401-3054
Phone 218-829-2861 · Fax 218-828-3130
Mailing address
523 N 3rd StBrainerd, MN 56401-3054
Phone 218-829-2861
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This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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