Provider Demographics
NPI:1063868990
Name:KNIGHT, STEPHANIE R
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:R
Last Name:KNIGHT
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 1:1508 I ST
Mailing Address - Street 2:
Mailing Address - City:GENEVA
Mailing Address - State:NE
Mailing Address - Zip Code:68361-1532
Mailing Address - Country:US
Mailing Address - Phone:402-759-3192
Mailing Address - Fax:402-759-3186
Practice Address - Street 1:1900 F ST
Practice Address - Street 2:FILLMORE COUNTY HOSPITAL
Practice Address - City:GENEVA
Practice Address - State:NE
Practice Address - Zip Code:68361-2229
Practice Address - Country:US
Practice Address - Phone:402-759-3192
Practice Address - Fax:402-759-3186
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-10
Last Update Date:2016-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NEP-988101YA0400X
NE1375101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)