Provider Demographics
NPI:1215635891
Name:DIETER, SARA RIANE (MSN, APRN, FNP-C)
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:RIANE
Last Name:DIETER
Suffix:
Gender:F
Credentials:MSN, APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:705 S RUSK ST
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:76240-5316
Mailing Address - Country:US
Mailing Address - Phone:903-821-1097
Mailing Address - Fax:
Practice Address - Street 1:1615 HOSPITAL BLVD STE A
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:TX
Practice Address - Zip Code:76240-2032
Practice Address - Country:US
Practice Address - Phone:940-641-3440
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-22
Last Update Date:2023-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1106367363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily