Provider Demographics
NPI:1952741456
Name:PULVERENTI, STEPHANIE ERIN (MSN, APRN, NP-C)
Entity Type:Individual
Prefix:MRS
First Name:STEPHANIE
Middle Name:ERIN
Last Name:PULVERENTI
Suffix:
Gender:F
Credentials:MSN, APRN, NP-C
Other - Prefix:
Other - First Name:STEPHANIE
Other - Middle Name:ERIN
Other - Last Name:BOON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8200 DODGE ST
Mailing Address - Street 2:CHILDREN'S HOSPITAL & MEDICAL CENTER
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68114-4113
Mailing Address - Country:US
Mailing Address - Phone:402-955-5400
Mailing Address - Fax:
Practice Address - Street 1:8200 DODGE ST
Practice Address - Street 2:CHILDREN'S HOSPITAL & MEDICAL CENTER - NEUROLOGY
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68114-4113
Practice Address - Country:US
Practice Address - Phone:402-955-5372
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-28
Last Update Date:2013-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE111514363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner