Individual
STACIE RAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S. CCC-A
Contact information
Practice address
253 BARKLEY MEMORIAL CENTER, LINCOLN, NE 68583-0731
(402) 472-2068
Mailing address
253 BARKLEY MEMORIAL CENTER, LINCOLN, NE 68583-0731
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
220
NE
237600000X
Audiologist-Hearing Aid Fitter
694
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10025369300
—
NE
05
—
10025369400
—
NE
01
—
220
NE AUDIOLOGY LICENSE
NE
01
—
37023
BCBS
NE
01
—
694
NE HEARING AID DISPENSER
NE
01
—
P00337281
RAILROAD MEDICARE PIN
—
Enumeration date
04/11/2006
Last updated
07/11/2007
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