Individual
STEFANIE L BOLTE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
10707 PACIFIC ST, SUITE 101, OMAHA, NE 68114-4762
(402) 397-7989
(402) 393-7554
Mailing address
PO BOX 8577, OMAHA, NE 68108-0577
(402) 397-7989
(402) 397-8703
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
23778
NE
208800000X
Urology Physician
36776
IA
208800000X
Urology Physician
44887
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
098396
MEDICARE
NE
Enumeration date
05/15/2006
Last updated
03/27/2013
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