Individual
DIANE E PROVOST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
107 E BROOKLYN AVE, DONIPHAN, NE 68832-9647
(308) 380-8433
Mailing address
107 E BROOKLYN AVE, DONIPHAN, NE 68832-9647
(308) 380-8433
Taxonomy
Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary
—
NE
Other
Enumeration date
11/21/2025
Last updated
11/21/2025
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