# MRS. REBECCA J DIETZ

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1336469550
- **Gender:** F
- **Credential:** APRN

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363L00000X | Nurse Practitioner | 111098 | NE | Yes |
| 363L00000X | Nurse Practitioner | A139805 | IA | — |

## Other

- **Enumeration date:** 06/10/2010
- **Last updated:** 08/24/2017

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 098684515 | MEDICARE PTAN | NE |