Healthcare Provider Details

I. General information

NPI: 1376267328
Provider Name (Legal Business Name): DAWN MARIE SPLATTSTOESSER RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/03/2022
Last Update Date: 10/30/2024
Certification Date: 10/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3563 PRAIRIEVIEW ST STE 200
GRAND ISLAND NE
68803-4442
US

IV. Provider business mailing address

4030 INDIANHEAD DR # FR
GRAND ISLAND NE
68803-6431
US

V. Phone/Fax

Practice location:
  • Phone: 308-270-7167
  • Fax: 308-398-1503
Mailing address:
  • Phone: 308-379-8203
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number63037
License Number StateNE
# 2
Primary TaxonomyY
Taxonomy Code163WD0400X
TaxonomyDiabetes Educator Registered Nurse
License Number63037
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: