Individual
TANYA RANDI ANN NISSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
420 VICTORY PARK DR, LINCOLN, NE 68510-2484
(402) 489-3802
(612) 725-1308
Mailing address
8835 APPALOOSA LN, LINCOLN, NE 68520-1521
(678) 523-2102
(612) 725-1308
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
87945
NE
Other
Enumeration date
07/19/2024
Last updated
07/19/2024
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