Individual
STEPHANIE A WISHNEV
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
6020 S. JONES BLVD, LAS VEGAS, NV 89118-2310
(702) 739-6467
(702) 733-1689
Mailing address
PO BOX 50607, HENDERSON, NV 89016-0607
Taxonomy
Speciality
Code
Description
License number
State
208C00000X
Colon & Rectal Surgery Physician
Primary
8168
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002002280
—
NV
Enumeration date
07/15/2005
Last updated
07/06/2023
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