Provider Demographics
NPI:1669733085
Name:MARCY, STEPHANIE LYNN (DO)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:LYNN
Last Name:MARCY
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 W. LEOTA ST.
Mailing Address - Street 2:ANES: ANESTHESIOLOGY
Mailing Address - City:NORTH PLATTE
Mailing Address - State:NE
Mailing Address - Zip Code:69101
Mailing Address - Country:US
Mailing Address - Phone:308-568-8470
Mailing Address - Fax:308-568-7469
Practice Address - Street 1:601 W LEOTA STREET
Practice Address - Street 2:ANES: ANESTHESIOLOGY
Practice Address - City:NORTH PLATTE
Practice Address - State:NE
Practice Address - Zip Code:69101
Practice Address - Country:US
Practice Address - Phone:308-568-8470
Practice Address - Fax:308-535-7469
Is Sole Proprietor?:No
Enumeration Date:2012-06-01
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA390200000X
NE1654207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program