Provider Demographics
NPI:1033072459
Name:STUKENHOLTZ, ANNAMARIE MAE
Entity type:Individual
Prefix:
First Name:ANNAMARIE
Middle Name:MAE
Last Name:STUKENHOLTZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:707 E ELDORA AVE
Mailing Address - Street 2:
Mailing Address - City:WEEPING WATER
Mailing Address - State:NE
Mailing Address - Zip Code:68463-4325
Mailing Address - Country:US
Mailing Address - Phone:402-209-5638
Mailing Address - Fax:
Practice Address - Street 1:707 E ELDORA AVE
Practice Address - Street 2:
Practice Address - City:WEEPING WATER
Practice Address - State:NE
Practice Address - Zip Code:68463-4325
Practice Address - Country:US
Practice Address - Phone:402-209-5638
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-12-03
Last Update Date:2025-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE372500000X, 3747P1801X, 372600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes372600000XNursing Service Related ProvidersAdult Companion
No372500000XNursing Service Related ProvidersChore Provider
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Single Specialty