Individual
MRS. PAIGE STANZEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
610 JEFFERSON ST, WATERLOO, NE 68069-2212
(402) 658-3150
Mailing address
610 JEFFERSON ST, WATERLOO, NE 68069-2212
(402) 658-3150
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2524
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2524
PHYSICIAN ASSISTANT STATE LICENSE
NE
Enumeration date
09/04/2020
Last updated
09/04/2020
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