Provider Demographics
NPI:1558447177
Name:STONEKING, BRIAN J (APRN)
Entity Type:Individual
Prefix:
First Name:BRIAN
Middle Name:J
Last Name:STONEKING
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7100 W CENTER RD
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68106-2700
Mailing Address - Country:US
Mailing Address - Phone:402-506-9000
Mailing Address - Fax:402-261-0243
Practice Address - Street 1:7100 W CENTER RD
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68106-2700
Practice Address - Country:US
Practice Address - Phone:402-506-9000
Practice Address - Fax:402-261-0243
Is Sole Proprietor?:No
Enumeration Date:2006-10-27
Last Update Date:2015-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE110712363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE110712OtherSTATE LICENSE