Provider Demographics
NPI:1497849475
Name:STEPHENSON, YVONNE M (MD)
Entity Type:Individual
Prefix:DR
First Name:YVONNE
Middle Name:M
Last Name:STEPHENSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5310 S 84TH ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68127-3775
Mailing Address - Country:US
Mailing Address - Phone:402-827-6510
Mailing Address - Fax:402-827-6517
Practice Address - Street 1:5370 S 84TH ST STE A
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68127-3774
Practice Address - Country:US
Practice Address - Phone:402-390-0555
Practice Address - Fax:402-926-4793
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2018-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE18737207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE272616STMedicare PIN
NE278676Medicare PIN
NEF44242Medicare UPIN