Healthcare Provider Details

I. General information

NPI: 1164618666
Provider Name (Legal Business Name): DIANNA CLYNE MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/18/2007
Last Update Date: 12/29/2025
Certification Date: 12/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6500 HOLDREGE ST
LINCOLN NE
68505-1673
US

IV. Provider business mailing address

6500 HOLDREGE ST
LINCOLN NE
68505-1673
US

V. Phone/Fax

Practice location:
  • Phone: 402-476-7557
  • Fax: 402-476-9912
Mailing address:
  • Phone: 402-476-7557
  • Fax: 402-476-9912

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: DIANNA CLYNE
Title or Position: OWNER
Credential: MD
Phone: 402-476-7557