Individual
DIANE KAE JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
A.P.R.N.
Contact information
Practice address
727 E 1ST ST, MINDEN, NE 68959-1705
(308) 832-3400
Mailing address
727 E 1ST ST, MINDEN, NE 68959-1705
(308) 832-3400
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
110613
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
47600743612
—
NE
05
—
47600743621
—
NE
05
—
47600743622
—
NE
05
—
47600743623
—
NE
Enumeration date
06/08/2006
Last updated
08/29/2023
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