Individual
KENDRA MARIE STACHUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3907 S 207TH ST, ELKHORN, NE 68022-2987
(402) 202-5295
Mailing address
3907 S 207TH ST, ELKHORN, NE 68022-2987
(402) 202-5295
Taxonomy
Speciality
Code
Description
License number
State
372500000X
Chore Provider
Primary
—
—
372600000X
Adult Companion
—
—
Other
Enumeration date
02/20/2025
Last updated
06/15/2025
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