Provider Demographics
NPI:1003963067
Name:GRIESER, ANDREA ANN (DC)
Entity Type:Individual
Prefix:DR
First Name:ANDREA
Middle Name:ANN
Last Name:GRIESER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7405 PIONEERS BLVD
Mailing Address - Street 2:SUITE E
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68506-7554
Mailing Address - Country:US
Mailing Address - Phone:402-483-4646
Mailing Address - Fax:402-486-4649
Practice Address - Street 1:7405 PIONEERS BLVD
Practice Address - Street 2:SUITE E
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68506-7554
Practice Address - Country:US
Practice Address - Phone:402-483-4646
Practice Address - Fax:402-486-4649
Is Sole Proprietor?:No
Enumeration Date:2007-01-04
Last Update Date:2011-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1363111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE100251926-00Medicaid
NE099646Medicare ID - Type UnspecifiedPROVIDER NUMBER