Provider Demographics
NPI:1477049013
Name:DINEEN, EILEEN MARIE (NP)
Entity Type:Individual
Prefix:
First Name:EILEEN
Middle Name:MARIE
Last Name:DINEEN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:EILEEN
Other - Middle Name:MARIE
Other - Last Name:DWORAK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:14161 FRANKLIN ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68154-3865
Mailing Address - Country:US
Mailing Address - Phone:402-301-1426
Mailing Address - Fax:
Practice Address - Street 1:14161 FRANKLIN ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68154-3865
Practice Address - Country:US
Practice Address - Phone:402-301-1426
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-06
Last Update Date:2018-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE112503363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology