Individual
DR. KENNETH MCCORD TIERNEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
APRN
Contact information
Practice address
2500 CALIFORNIA PLZ, OMAHA, NE 68178-0133
(402) 280-2251
Mailing address
5621 PINE ST, OMAHA, NE 68106-2210
(402) 990-2140
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
112609
NE
Other
Enumeration date
08/25/2018
Last updated
08/25/2018
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