Provider Demographics
NPI:1689141830
Name:STEHMAN, KILEY COLLEEN (RN)
Entity Type:Individual
Prefix:
First Name:KILEY
Middle Name:COLLEEN
Last Name:STEHMAN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8005 MARISU LN
Mailing Address - Street 2:
Mailing Address - City:LA VISTA
Mailing Address - State:NE
Mailing Address - Zip Code:68128-2735
Mailing Address - Country:US
Mailing Address - Phone:402-210-9348
Mailing Address - Fax:
Practice Address - Street 1:504 S WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:PAPILLION
Practice Address - State:NE
Practice Address - Zip Code:68046-2632
Practice Address - Country:US
Practice Address - Phone:402-898-1970
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-25
Last Update Date:2018-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE63151163WP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0200XNursing Service ProvidersRegistered NursePediatrics