Individual
MRS. STEPHANIE ELLEN MCCORMICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
2727 S 144TH ST, OMAHA, NE 68144-5225
(402) 778-5200
(402) 778-5216
Mailing address
2727 S 144TH ST, OMAHA, NE 68144-5225
(402) 778-5200
(402) 778-5216
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
0000032
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000032
STATE OF COLORADO LICENSE
CO
05
—
07683731
—
CO
Enumeration date
10/31/2012
Last updated
08/15/2014
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