Healthcare Provider Details

I. General information

NPI: 1013669662
Provider Name (Legal Business Name): SIERRA FRICKEY RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/25/2022
Last Update Date: 01/25/2022
Certification Date: 01/25/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

505 CENTER AVE
MORRILL NE
69358-3003
US

IV. Provider business mailing address

508 JEFFERSON AVE
MORRILL NE
69358-5013
US

V. Phone/Fax

Practice location:
  • Phone: 308-247-3414
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License Number84341
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: