Individual
KAITLYN STUKENHOLTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
10819 S 192ND AVE, GRETNA, NE 68028-3646
(531) 213-3628
Mailing address
10819 S 192ND AVE, GRETNA, NE 68028-3646
(531) 213-3628
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
9894
NE
Other
Enumeration date
08/01/2024
Last updated
08/01/2024
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