Provider Demographics
NPI:1922402684
Name:OWEN, STEFANY LYNN
Entity Type:Individual
Prefix:
First Name:STEFANY
Middle Name:LYNN
Last Name:OWEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2401 PLUM CREEK PKWY
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:NE
Mailing Address - Zip Code:68850-2813
Mailing Address - Country:US
Mailing Address - Phone:308-325-2046
Mailing Address - Fax:308-324-5481
Practice Address - Street 1:2401 PLUM CREEK PKWY
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:NE
Practice Address - Zip Code:68850-2813
Practice Address - Country:US
Practice Address - Phone:308-325-2046
Practice Address - Fax:308-324-5481
Is Sole Proprietor?:No
Enumeration Date:2014-10-09
Last Update Date:2014-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator