Healthcare Provider Details

I. General information

NPI: 1336034289
Provider Name (Legal Business Name): STEFANIE RAIKO MCKNIGHT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: STEFANIE RAIKO ROBINSON

II. Dates (important events)

Enumeration Date: 06/11/2025
Last Update Date: 06/11/2025
Certification Date: 06/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

818 HIDDEN HILLS DR
BELLEVUE NE
68005-2738
US

IV. Provider business mailing address

3517 N 25TH ST
OMAHA NE
68111-2901
US

V. Phone/Fax

Practice location:
  • Phone: 402-660-1007
  • Fax:
Mailing address:
  • Phone: 402-575-8060
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: