Healthcare Provider Details

I. General information

NPI: 1932874963
Provider Name (Legal Business Name): LAUREN ELIZABETH STEPHENS PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/11/2021
Last Update Date: 05/10/2023
Certification Date: 05/10/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5533 S 27TH ST STE 103
LINCOLN NE
68512-1664
US

IV. Provider business mailing address

5533 S 27TH ST STE 103
LINCOLN NE
68512-1664
US

V. Phone/Fax

Practice location:
  • Phone: 402-423-7000
  • Fax: 402-423-9399
Mailing address:
  • Phone: 402-423-7000
  • Fax: 402-423-9399

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number2668
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: