Provider Demographics
NPI:1134877178
Name:ALLEVIATE ENTERPRISE LLC
Entity type:Organization
Organization Name:ALLEVIATE ENTERPRISE LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ANESTHESIOLOGIST/SOLE PROPRIETOR
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHAIE
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:RANDALL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:402-499-2935
Mailing Address - Street 1:9120 MONTELLO RD
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68520-1473
Mailing Address - Country:US
Mailing Address - Phone:402-499-2935
Mailing Address - Fax:
Practice Address - Street 1:5620 S 27TH ST
Practice Address - Street 2:SUITE 200
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68516
Practice Address - Country:US
Practice Address - Phone:402-890-8639
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-17
Last Update Date:2022-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty