Provider Demographics
NPI:1629689161
Name:STEGMANN, ALICE MARIA (RN, IBCLC)
Entity Type:Individual
Prefix:
First Name:ALICE
Middle Name:MARIA
Last Name:STEGMANN
Suffix:
Gender:F
Credentials:RN, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13355 N US HIGHWAY 183 APT 1611
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78750-7144
Mailing Address - Country:US
Mailing Address - Phone:269-312-0384
Mailing Address - Fax:
Practice Address - Street 1:13355 N US HIGHWAY 183 APT 1611
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78750-7144
Practice Address - Country:US
Practice Address - Phone:269-312-0384
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-10
Last Update Date:2020-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX953380163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant