Provider Demographics
NPI:1548377682
Name:DENAEYER, STEPHANIE D (DC)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:D
Last Name:DENAEYER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:312 SOUTH DEWEY
Mailing Address - Street 2:SUITE 1
Mailing Address - City:NORTH PLATTE
Mailing Address - State:NE
Mailing Address - Zip Code:69101-5473
Mailing Address - Country:US
Mailing Address - Phone:308-532-0234
Mailing Address - Fax:308-532-0370
Practice Address - Street 1:312 SOUTH DEWEY
Practice Address - Street 2:SUITE 1
Practice Address - City:NORTH PLATTE
Practice Address - State:NE
Practice Address - Zip Code:69101-5473
Practice Address - Country:US
Practice Address - Phone:308-532-0234
Practice Address - Fax:308-532-0370
Is Sole Proprietor?:No
Enumeration Date:2006-08-24
Last Update Date:2011-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1355111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NEP00304269OtherR R MEDICARE
NE100252297-00Medicaid
09530OtherBCBS
NE278223001Medicare PIN
NEP00304269OtherR R MEDICARE