Provider Demographics
NPI:1952708208
Name:DIBBERN, JAMIE LEE (FNP-C)
Entity type:Individual
Prefix:MRS
First Name:JAMIE
Middle Name:LEE
Last Name:DIBBERN
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1806 E 12TH RD
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:NE
Mailing Address - Zip Code:68818-7916
Mailing Address - Country:US
Mailing Address - Phone:402-631-7878
Mailing Address - Fax:
Practice Address - Street 1:609 O ST
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:NE
Practice Address - Zip Code:68818-1100
Practice Address - Country:US
Practice Address - Phone:402-694-3191
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-12-02
Last Update Date:2023-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE114943363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily