Glen Deitrick, C.R.N.A
NPI 1033214564 · Certified Registered Nurse Anesthetist · Gulfport, MS
Glen Deitrick, C.R.N.A is a Certified Registered Nurse Anesthetist provider in Gulfport, MS (NPI 1033214564).
Provider details
- NPI number
- 1033214564
- Entity type
- Individual
- Primary specialty
- Certified Registered Nurse AnesthetistPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- C.R.N.A
- Sex
- Male
- Sole proprietor
- Yes
- License
- R128610 (MS)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2006-09-13
- Last updated
- 2007-07-08
Frequently asked questions
- What is Glen Deitrick's NPI number?
- Glen Deitrick's National Provider Identifier (NPI) is 1033214564, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Glen Deitrick's specialty?
- Glen Deitrick is listed in the NPPES registry with a primary specialty of Certified Registered Nurse Anesthetist (Physician Assistants & Advanced Practice Nursing Providers).
- Where is Glen Deitrick located?
- Glen Deitrick's practice location on file with NPPES is 15190 Community Rd, Gulfport, MS 39503-3485.
- What is Glen Deitrick's phone number?
- The practice phone number listed in the NPPES registry for Glen Deitrick is (228) 831-0204.
- Is Glen Deitrick's NPI active?
- Yes — Glen Deitrick's NPI (1033214564) is active in the NPPES registry as of the last update on 2007-07-08.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.