Provider Demographics
NPI:1215402904
Name:STANEK, MEGAN ANN
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:ANN
Last Name:STANEK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1720 S 48TH ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68106-2507
Mailing Address - Country:US
Mailing Address - Phone:402-554-8570
Mailing Address - Fax:
Practice Address - Street 1:1720 S 48TH ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68106-2507
Practice Address - Country:US
Practice Address - Phone:402-554-8570
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-09
Last Update Date:2018-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE75496163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool