Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | 28505 | NE |
NPI | 1013243740 |
---|---|
Provider Name | Dr. Stephanie Lynn Fisher Gustin |
First Address | Omaha, NE 68138-6804 |
Second Address | Omaha, NE 68138-6804 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/10/2009 |
Last Update Date | 17/08/2015 |