Individual
KIMBERLY J DIERKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.-C
Contact information
Practice address
139 S 40TH ST, OMAHA, NE 68131-3003
(402) 595-3939
(402) 595-3898
Mailing address
988102 NEBRASKA MEDICAL CTR, OMAHA, NE 68198-8102
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
001733
IA
363A00000X
Physician Assistant
Primary
1108
NE
Other
Enumeration date
08/25/2005
Last updated
08/17/2017
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