Individual
MRS. STACEY BROOK WATNE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
8901 WEST DODGE RD, OMAHA, NE 68114-3321
(402) 354-8990
(402) 354-8645
Mailing address
PO BOX 3755, OMAHA, NE 68103-0755
(402) 354-5677
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
113565
NE
Other
Enumeration date
10/27/2021
Last updated
10/27/2021
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