Individual
MS. STACIE ANN WITHERSPOON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
5606 S 147TH ST, OMAHA, NE 68137-2647
(402) 715-8200
Mailing address
5606 S 147TH ST, OMAHA, NE 68137-2647
(402) 715-8200
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
62094
NE
Other
Enumeration date
08/29/2018
Last updated
08/29/2018
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