Healthcare Provider Details

I. General information

NPI: 1982514691
Provider Name (Legal Business Name): JEFFREY ALLEN STEWART
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/08/2026
Last Update Date: 09/08/2026
Certification Date: 09/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

403 W CEDAR ST
DONIPHAN NE
68832
US

IV. Provider business mailing address

PO BOX 102
DONIPHAN NE
68832-0102
US

V. Phone/Fax

Practice location:
  • Phone: 308-390-2904
  • Fax:
Mailing address:
  • Phone: 308-390-2904
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: