Individual
STACY D BLUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1301 GRUNDMAN BLVD STE A, NEBRASKA CITY, NE 68410-3320
(402) 873-4242
Mailing address
1301 GRUNDMAN BLVD STE A, NEBRASKA CITY, NE 68410-3320
(402) 873-4242
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
22314
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00800
BCBS
NE
01
—
01-06552
UHC
NE
05
—
10025323000
—
NE
05
—
10025440000
—
NE
01
—
234550
MIDLAND'S CHOICE
NE
05
—
7717070
—
SD
05
—
8215335
—
IA
Enumeration date
08/02/2006
Last updated
02/16/2018
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