Provider Demographics
NPI:1235426602
Name:GRABOWSKI, STEPHANIE N (OD)
Entity Type:Individual
Prefix:DR
First Name:STEPHANIE
Middle Name:N
Last Name:GRABOWSKI
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 N EDDY ST
Mailing Address - Street 2:
Mailing Address - City:GRAND ISLAND
Mailing Address - State:NE
Mailing Address - Zip Code:68801-4558
Mailing Address - Country:US
Mailing Address - Phone:308-384-6922
Mailing Address - Fax:
Practice Address - Street 1:401 N EDDY ST
Practice Address - Street 2:
Practice Address - City:GRAND ISLAND
Practice Address - State:NE
Practice Address - Zip Code:68801-4558
Practice Address - Country:US
Practice Address - Phone:308-384-6922
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-06
Last Update Date:2011-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1363152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist