Individual
MRS. REBECCA J DIETZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
EMILE AT 42ND ST, OMAHA, NE 68198-2027
(402) 559-8888
(402) 559-3060
Mailing address
988102 NEBRASKA MEDICAL CTR, OMAHA, NE 68198-8102
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
111098
NE
363L00000X
Nurse Practitioner
A139805
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
098684515
MEDICARE PTAN
NE
Enumeration date
06/10/2010
Last updated
08/24/2017
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