Holly Diedrich, RN

Primary specialty

School Registered NurseTaxonomy code 163WS0200X

License

57947 Issued in NM

Practice address

24 Public School Rd
Tijeras, NM 87059-8600

Phone

(505) 281-0880

NPI assigned

Oct 12, 2022

Last updated

Oct 12, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1665532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665532800000",
    "number": "1407572498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 25704",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871250704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 PUBLIC SCHOOL RD",
            "city": "TIJERAS",
            "state": "NM",
            "postal_code": "870598600",
            "telephone_number": "505-281-0880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIEDRICH",
        "first_name": "HOLLY",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-10-12",
        "last_updated": "2022-10-12",
        "certification_date": "2022-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WS0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, School",
            "state": "NM",
            "license": "57947",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Camille Ross Coffey, DC
• Kristin Lynnette Collado
• Kimberyly Collins, SW
• Kathryn Conticelli
• Robert O. Costa, LMT
• Patricia A Drey, CNP
• Terri P Elisberg, R.D.,L.D.,C.D.E.
• Enchanted Healing of New Mexico LLC
• Essence of Life Therapy and Wellness, LLC
• Eileen Farrell

• School Registered Nurse in Tijeras, NM
• Providers in Tijeras, NM by specialty
• School Registered Nurse in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.