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General NPI Number Information
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NPI Number | 1154171460
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Entity Type | Individual
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Provider Name | STEPHANIE KAY CONDON CNA
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Gender | Female
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Dates
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Enumeration Date | 03/27/2024
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Last Update Date | 03/27/2024
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Provider Practice Location Address
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Address Line | 113 MAKOCHMNI
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City | OGALLALA
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State | NE
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Zip | 69153-5802
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Country | US
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Telephone | 308-464-0287
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Fax |
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Provider Business Mailing Address
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Address Line | 1701 E 2ND ST APT 141
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City | OGALLALA
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State | NE
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Zip | 69153-2937
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Country | US
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Telephone | 308-353-1986
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number |
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License Number State |
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