Provider Demographics
NPI:1306626841
Name:WIMER, DIXIE (CNA)
Entity type:Individual
Prefix:
First Name:DIXIE
Middle Name:
Last Name:WIMER
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1015 M ST
Mailing Address - Street 2:
Mailing Address - City:TEKAMAH
Mailing Address - State:NE
Mailing Address - Zip Code:68061-1431
Mailing Address - Country:US
Mailing Address - Phone:402-870-0530
Mailing Address - Fax:
Practice Address - Street 1:1015 M ST
Practice Address - Street 2:
Practice Address - City:TEKAMAH
Practice Address - State:NE
Practice Address - Zip Code:68061-1431
Practice Address - Country:US
Practice Address - Phone:402-870-0530
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-03
Last Update Date:2023-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE149455376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide