Individual
TAMA DIERKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
160 CHADRON AVE, CHADRON, NE 69337-2346
(308) 432-5521
Mailing address
160 CHADRON AVE, CHADRON, NE 69337-2346
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
12302
NE
Other
Enumeration date
03/26/2025
Last updated
03/26/2025
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