Individual provider Active NPI

Stacy L Diekmann, RN

  • Registered Nurse
  • Eagle, NE
National Provider Identifier
1790037851
Registry record updated Oct 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
73996 Issued in NE
Practice address
710 Maple Dr
Eagle, NE 68347-2110
Phone
(402) 477-3951
NPI assigned
Oct 12, 2012
Last updated
Oct 12, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 73996 NE Primary

Addresses

Primary practice location

710 Maple Dr
Eagle, NE 68347-2110

Mailing address

710 Maple Dr
Eagle, NE 68347-2110

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
73996NEMDRegistered Nurse

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1350000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350000000000",
    "number": "1790037851",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "710 MAPLE DR",
            "city": "EAGLE",
            "state": "NE",
            "postal_code": "683472110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 MAPLE DR",
            "city": "EAGLE",
            "state": "NE",
            "postal_code": "683472110",
            "telephone_number": "402-477-3951"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIEKMANN",
        "first_name": "STACY",
        "middle_name": "L",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-12",
        "last_updated": "2012-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NE",
            "license": "73996",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eagle, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.