Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 1363 | NE |
NPI | 1003963067 |
---|---|
Provider Name | Dr. Andrea Ann Grieser |
First Address | Lincoln, NE 68506-7554 |
Second Address | Lincoln, NE 68506-7554 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/01/2007 |
Last Update Date | 28/04/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
100251926-00 | (05) | NE |