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General NPI Number Information
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NPI Number | 1134877178
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Entity Type | Organization
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Legal Business Name | ALLEVIATE ENTERPRISE LLC
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Dates
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Enumeration Date | 03/17/2022
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Last Update Date | 06/29/2022
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Provider Practice Location Address
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Address Line | 5620 S 27TH ST SUITE 200
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City | LINCOLN
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State | NE
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Zip | 68516
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Country | US
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Telephone | 402-890-8639
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Fax |
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Provider Business Mailing Address
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Address Line | 9120 MONTELLO RD
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City | LINCOLN
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State | NE
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Zip | 68520-1473
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Country | US
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Telephone | 402-499-2935
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Fax |
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Authorized Official
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Title or Position | ANESTHESIOLOGIST/SOLE PROPRIETOR
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Name | DR. STEPHAIE LYNN RANDALL
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Credential | MD
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Telephone | 402-499-2935
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number |
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License Number State |
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