Dietra Angelly, FNP-C

NPI 1902371313 · on the registry since 2018 · sole proprietor

Practice

Address: 3411 Professional Park Dr
Marion, IL 62959
Phone: (618) 969-8630
Fax: (618) 993-1421
Organisation at this address: Deaconess Illinois Clinic, Inc
Southern Illinois Medical Care Associates Llc
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 8

Registry record

Primary taxonomy: Nurse Practitioner
363L00000X
Also registered as: Family Nurse Practitioner
Licence states on file: IL
From the registry's licence fields, which are often incomplete.
Sex: Female
Record last updated: 2024-04-08

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Illinois