Provider Demographics
NPI:1922420934
Name:ROMERO, STEPHANIE (LATC, MPA)
Entity Type:Individual
Prefix:MRS
First Name:STEPHANIE
Middle Name:
Last Name:ROMERO
Suffix:
Gender:F
Credentials:LATC, MPA
Other - Prefix:
Other - First Name:STEPHANIE
Other - Middle Name:
Other - Last Name:LINDHORST
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LATC, MPA
Mailing Address - Street 1:8708 S 164TH ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68136-1364
Mailing Address - Country:US
Mailing Address - Phone:402-920-0964
Mailing Address - Fax:
Practice Address - Street 1:1821 N 90TH ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68114-1314
Practice Address - Country:US
Practice Address - Phone:402-920-0964
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-09
Last Update Date:2014-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE6582255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer