Healthcare Provider Details

I. General information

NPI: 1033147285
Provider Name (Legal Business Name): DANIEL MERRICK STEVENS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/28/2006
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1820 N ST
ORD NE
68862-1623
US

IV. Provider business mailing address

1820 N ST
ORD NE
68862-1623
US

V. Phone/Fax

Practice location:
  • Phone: 308-728-9916
  • Fax: 308-728-3274
Mailing address:
  • Phone: 308-728-9916
  • Fax: 308-728-3274

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number19294
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: