Healthcare Provider Details

I. General information

NPI: 1619801818
Provider Name (Legal Business Name): QUENTIN LAMAR STEPHENS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/11/2026
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5770 THOMPSON CREEK BLVD
LINCOLN NE
68516-5685
US

IV. Provider business mailing address

5770 THOMPSON CREEK BLVD
LINCOLN NE
68516-5685
US

V. Phone/Fax

Practice location:
  • Phone: 402-600-3076
  • Fax:
Mailing address:
  • Phone: 402-600-3076
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: