Individual
MS. STEPHANE P VANDERMEULEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA C
Contact information
Practice address
2725 SOUTH 144TH STREET, SUITE 212, OMAHA, NE 68144
(402) 637-0800
(402) 637-0852
Mailing address
2725 SOUTH 144TH STREET, SUITE 212, OMAHA, NE 68144
(402) 637-0800
(402) 637-0852
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
624
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
38626
BCBS OF NE
NE
Enumeration date
07/31/2006
Last updated
03/12/2008
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