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General NPI Number Information
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NPI Number | 1154209245
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Entity Type | Individual
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Provider Name | KIMBERLY A WIESE APRN
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Gender | Female
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Dates
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Enumeration Date | 08/26/2025
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Last Update Date | 08/26/2025
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Provider Practice Location Address
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Address Line | 102 W 9TH ST
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City | NELIGH
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State | NE
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Zip | 68756-1114
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Country | US
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Telephone | 402-887-4151
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 229
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City | NELIGH
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State | NE
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Zip | 68756-0229
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Country | US
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Telephone | 402-887-4151
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Fax | 402-887-4092
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 116250
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License Number State | NE
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