Provider Demographics
NPI:1437678448
Name:BOLLINGER, STEPHANIE DEANNE (CNP)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:DEANNE
Last Name:BOLLINGER
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2222 S 16TH ST STE 400A
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68502-3785
Mailing Address - Country:US
Mailing Address - Phone:402-481-6343
Mailing Address - Fax:
Practice Address - Street 1:5901 N 27TH ST STE 101
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68521-4752
Practice Address - Country:US
Practice Address - Phone:402-481-6343
Practice Address - Fax:402-483-8831
Is Sole Proprietor?:No
Enumeration Date:2017-09-12
Last Update Date:2022-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2017032882363L00000X
NE113924363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner