Provider Demographics
NPI:1700083953
Name:BURGE, STEPHANIE ANN (APRN)
Entity Type:Individual
Prefix:MS
First Name:STEPHANIE
Middle Name:ANN
Last Name:BURGE
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1917 W 24TH ST
Mailing Address - Street 2:WEST CENTER, 155W
Mailing Address - City:KEARNEY
Mailing Address - State:NE
Mailing Address - Zip Code:68849-4915
Mailing Address - Country:US
Mailing Address - Phone:308-865-8745
Mailing Address - Fax:308-865-8186
Practice Address - Street 1:1917 W 24TH ST
Practice Address - Street 2:WEST CENTER, 155W
Practice Address - City:KEARNEY
Practice Address - State:NE
Practice Address - Zip Code:68849-4915
Practice Address - Country:US
Practice Address - Phone:308-865-8745
Practice Address - Fax:308-865-8186
Is Sole Proprietor?:No
Enumeration Date:2007-06-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE110118363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily