Doctor Name: | STEPHANIE STEVENS |
NPI Number: | 1356602718 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 292 |
Business Practice Address: | 12393 B Rd Polk, NE - 68654 |
Business Phone Number: | 4023620436 |
Business Fax Number: | |
Mailing Address: | 12393 B Rd, POLK |
State: | NE |
Postal Code: | 68654 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 06/01/2012 |
NPI Last Update Date: | 06/01/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2251G0304X |
License Number: | 292 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NE |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | Geriatrics |
Taxonomy Definition: |