Individual
DIEDRA THIES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1021 N 27TH ST, LINCOLN, NE 68503-1803
(402) 476-1455
(402) 476-1670
Mailing address
1021 N 27TH ST, LINCOLN, NE 68503-1803
(402) 476-1455
(402) 476-1670
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
112018
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10025024300
—
NE
05
—
10025024400
—
NE
Enumeration date
06/14/2016
Last updated
06/20/2016
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