Individual
JARED DIETZE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
618 N DENVER AVE, HASTINGS, NE 68901-5122
(402) 834-2450
(402) 834-2449
Mailing address
618 N DENVER AVE, HASTINGS, NE 68901-5122
(402) 834-2450
(402) 834-2449
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
34720
NE
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
34720
MEDICAL LICENSE
NE
Enumeration date
03/30/2017
Last updated
07/18/2022
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