Provider Demographics
NPI:1841260759
Name:STEHN, LORRAINE S (DO)
Entity type:Individual
Prefix:
First Name:LORRAINE
Middle Name:S
Last Name:STEHN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 W WILSON AVE
Mailing Address - Street 2:
Mailing Address - City:ARANSAS PASS
Mailing Address - State:TX
Mailing Address - Zip Code:78336-2528
Mailing Address - Country:US
Mailing Address - Phone:361-758-2799
Mailing Address - Fax:361-758-2707
Practice Address - Street 1:201 W WILSON AVE
Practice Address - Street 2:
Practice Address - City:ARANSAS PASS
Practice Address - State:TX
Practice Address - Zip Code:78336-2528
Practice Address - Country:US
Practice Address - Phone:361-758-2799
Practice Address - Fax:361-758-2707
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-24
Last Update Date:2020-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF7932207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX133365005Medicaid
A67699Medicare UPIN
00R44DMedicare ID - Type Unspecified
TXB102377Medicare PIN
TXTXB102376Medicare PIN