Provider Demographics
NPI:1053119370
Name:DIBBERN, CATINA MAE
Entity type:Individual
Prefix:
First Name:CATINA
Middle Name:MAE
Last Name:DIBBERN
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3814 MAJESTIC AVE
Mailing Address - Street 2:
Mailing Address - City:GRAND ISLAND
Mailing Address - State:NE
Mailing Address - Zip Code:68803-4100
Mailing Address - Country:US
Mailing Address - Phone:308-383-3122
Mailing Address - Fax:
Practice Address - Street 1:3814 MAJESTIC AVE
Practice Address - Street 2:
Practice Address - City:GRAND ISLAND
Practice Address - State:NE
Practice Address - Zip Code:68803-4100
Practice Address - Country:US
Practice Address - Phone:308-383-3122
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-04
Last Update Date:2025-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Single Specialty