Provider Demographics
NPI:1497565600
Name:KOESTERS, DIANE
Entity type:Individual
Prefix:
First Name:DIANE
Middle Name:
Last Name:KOESTERS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8010 S 40TH ST
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:NE
Mailing Address - Zip Code:68147-1887
Mailing Address - Country:US
Mailing Address - Phone:402-415-5918
Mailing Address - Fax:
Practice Address - Street 1:8010 S 40TH ST
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:NE
Practice Address - Zip Code:68147-1887
Practice Address - Country:US
Practice Address - Phone:402-415-5918
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-09
Last Update Date:2025-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion