Provider Demographics
NPI:1083332563
Name:OCHOA, STEPHANIE FERNANDEZ (BSN)
Entity Type:Individual
Prefix:MRS
First Name:STEPHANIE
Middle Name:FERNANDEZ
Last Name:OCHOA
Suffix:
Gender:F
Credentials:BSN
Other - Prefix:
Other - First Name:STEPHANIE
Other - Middle Name:
Other - Last Name:FERNANDEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4230 WAR EAGLE DR
Mailing Address - Street 2:
Mailing Address - City:SIOUX CITY
Mailing Address - State:IA
Mailing Address - Zip Code:51109-1700
Mailing Address - Country:US
Mailing Address - Phone:712-224-4308
Mailing Address - Fax:
Practice Address - Street 1:2116 A ST
Practice Address - Street 2:
Practice Address - City:SOUTH SIOUX CITY
Practice Address - State:NE
Practice Address - Zip Code:68776-3028
Practice Address - Country:US
Practice Address - Phone:402-494-4238
Practice Address - Fax:402-494-6300
Is Sole Proprietor?:No
Enumeration Date:2022-08-19
Last Update Date:2022-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA154737163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse