MEDICARE: MRS. ASHLEY RAE STEVENS AU.D

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	231H00000X	Audiologist	085	NE

General Provider Information

NPI Number	:	1861640799
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ASHLEY RAE STEVENS AU.D

Provider Business Mailing Address
First Line	:	9202 W DODGE RD
Second Line	:	SUITE 200
City	:	OMAHA
State	:	NE
Zip	:	68114-3343
Country	:	US
Telephone Number	:	402-933-3277
Fax Number	:	402-933-2216

Provider Business Practice Location Address
First Line	:	9202 WEST DODGE ROAD
Second Line	:	SUITE 200
City	:	OMAHA
State	:	NE
Zip	:	68114-3318
Country	:	US
Telephone Number	:	402-933-3277
Fax Number	:	402-933-2216

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/04/2008
Last Update Date	:	03/05/2014

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