Individual
DIANA MARIE WISNIESKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN/LPN-C/EMT
Contact information
Practice address
162 COUNTY ROAD 1, DODGE, NE 68633-4222
(402) 693-2532
Mailing address
162 COUNTY ROAD 1, DODGE, NE 68633-4222
Taxonomy
Speciality
Code
Description
License number
State
146N00000X
Basic Emergency Medical Technician
2123
NE
164W00000X
Licensed Practical Nurse
4198
NE
164W00000X
Licensed Practical Nurse
Primary
677 (LPN-C)
NE
Other
Enumeration date
09/05/2008
Last updated
09/05/2008
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