Healthcare Provider Details

I. General information

NPI: 1861640799
Provider Name (Legal Business Name): ASHLEY RAE STEVENS AU.D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/04/2008
Last Update Date: 03/05/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9202 WEST DODGE ROAD SUITE 200
OMAHA NE
68114-3318
US

IV. Provider business mailing address

9202 W DODGE RD SUITE 200
OMAHA NE
68114-3343
US

V. Phone/Fax

Practice location:
  • Phone: 402-933-3277
  • Fax: 402-933-2216
Mailing address:
  • Phone: 402-933-3277
  • Fax: 402-933-2216

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number085
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: