Provider Demographics
NPI:1891150355
Name:STUTZMAN, LEE (PHARMD, RP)
Entity Type:Individual
Prefix:DR
First Name:LEE
Middle Name:
Last Name:STUTZMAN
Suffix:
Gender:M
Credentials:PHARMD, RP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4900 N 27TH ST
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68521-1194
Mailing Address - Country:US
Mailing Address - Phone:402-438-3015
Mailing Address - Fax:402-438-3132
Practice Address - Street 1:4900 N 27TH ST
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68521-1194
Practice Address - Country:US
Practice Address - Phone:402-438-3015
Practice Address - Fax:402-438-3132
Is Sole Proprietor?:No
Enumeration Date:2015-12-28
Last Update Date:2015-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE12866183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE12866OtherSTATE LICENSE