Healthcare Provider Details

I. General information

NPI: 1518396092
Provider Name (Legal Business Name): TANYA KIER RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/05/2013
Last Update Date: 11/05/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1715 26TH ST
CENTRAL CITY NE
68826-9501
US

IV. Provider business mailing address

2113 P ST
AURORA NE
68818-1324
US

V. Phone/Fax

Practice location:
  • Phone: 308-946-3015
  • Fax:
Mailing address:
  • Phone: 402-631-7724
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number72981
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: