Individual provider Active NPI

Holly L Stephens, RN

  • Registered Nurse
  • Omaha, NE
National Provider Identifier
1053758813
Registry record updated Jun 3, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
128355 Issued in IA
Practice address
12565 W Center Rd
Suite 100
Omaha, NE 68144-3802
Phone
(402) 342-5566
Fax
(402) 342-0034
NPI assigned
Jun 3, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 128355 IA Primary

Addresses

Primary practice location

12565 W Center Rd
Suite 100
Omaha, NE 68144-3802

Mailing address

12565 W Center Rd
Suite 100
Omaha, NE 68144-3802
Phone (402) 342-5566

Other names 1

  • Miss Holly L Christensen Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
128355IAMDRegistered Nurse

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1370217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1370217600000",
    "number": "1053758813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12565 W CENTER RD",
            "address_2": "SUITE 100",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681443802",
            "telephone_number": "402-342-5566",
            "fax_number": "402-342-0034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12565 W CENTER RD",
            "address_2": "SUITE 100",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681443802",
            "telephone_number": "402-342-5566",
            "fax_number": "402-342-0034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEPHENS",
        "first_name": "HOLLY",
        "middle_name": "L",
        "name_prefix": "Ms.",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-03",
        "last_updated": "2013-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IA",
            "license": "128355",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HOLLY",
            "last_name": "CHRISTENSEN",
            "middle_name": "L",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Omaha, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.