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Individual

RACHEL L TIETZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
2700 W NORFOLK AVE, NORFOLK, NE 68701-4438
(402) 371-4880
(402) 644-7647
Mailing address
PO BOX 5126, SIOUX FALLS, SD 57117-5126
(605) 335-1952
(605) 373-9971

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
60805
NE

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
38170
BCBS
NE
01
P00760217
RAILROAD MEDICARE
NE
Enumeration date
06/01/2009
Last updated
02/21/2013
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