Provider Demographics
NPI:1851197743
Name:DIAMOND, JESSIE
Entity type:Individual
Prefix:
First Name:JESSIE
Middle Name:
Last Name:DIAMOND
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:220 S BEECROFT ST LOT 9E
Mailing Address - Street 2:
Mailing Address - City:ELM CREEK
Mailing Address - State:NE
Mailing Address - Zip Code:68836-7710
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1709 W 39TH ST
Practice Address - Street 2:
Practice Address - City:KEARNEY
Practice Address - State:NE
Practice Address - Zip Code:68845-8230
Practice Address - Country:US
Practice Address - Phone:308-236-8576
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-21
Last Update Date:2025-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes373H00000XNursing Service Related ProvidersDay Training/Habilitation Specialist