Individual
STEPHANIE A MISKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
7601 PIONEERS BLVD, LINCOLN, NE 68506
(402) 484-6677
(402) 484-4476
Mailing address
7601 PIONEERS BLVD, LINCOLN, NE 68506
(402) 484-6677
(402) 484-4476
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
18428
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10025760000
—
NE
05
—
47078180813
—
NE
05
—
47083161300
—
NE
01
—
P00951203
RR MEDICARE - AMI
NE
01
—
P00971287
RR MEDICARE - SMI
—
Enumeration date
11/07/2006
Last updated
09/24/2014
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