Gillian Diederich Wenzke, AG-ACNP
Nurse Practitioner in Dayton, OH. Individual provider (NPI-1).
NPI number1669925673
StatusActive
Last updated in NPPESNov 8, 2024
Details
- NPI
- 1669925673
- Entity type
- Individual (NPI-1)
- Name
- Mrs. Gillian Diederich Wenzke
- Credential
- AG-ACNP
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Jul 26, 2016
- Certification date
- Nov 6, 2024
- Last updated
- Nov 8, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363L00000X | Nurse Practitioner | CNP.019493 | OH | Yes |
Other names
- Gillian Margaret Diederich (Former Name)
Practice location
500 Lincoln Park BlvdSuite 100
Dayton, OH 45429-3492
Phone 937-222-3118 · Fax 937-222-1436
Mailing address
500 Lincoln Park BlvdSuite 100
Dayton, OH 45429-3492
Phone 937-222-3118 · Fax 937-222-1436
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