Provider Demographics
NPI:1437959012
Name:WOHLERS, STACY D'RAE (RESPITE)
Entity type:Individual
Prefix:
First Name:STACY
Middle Name:D'RAE
Last Name:WOHLERS
Suffix:
Gender:F
Credentials:RESPITE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:230 HOUGH RD
Mailing Address - Street 2:
Mailing Address - City:CRAWFORD
Mailing Address - State:NE
Mailing Address - Zip Code:69339-2100
Mailing Address - Country:US
Mailing Address - Phone:308-430-2211
Mailing Address - Fax:
Practice Address - Street 1:26 WHISPERING PNES
Practice Address - Street 2:
Practice Address - City:CHADRON
Practice Address - State:NE
Practice Address - Zip Code:69337-9362
Practice Address - Country:US
Practice Address - Phone:308-430-4541
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-13
Last Update Date:2025-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE19093405385H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care