Provider Demographics
NPI:1073312088
Name:STEPHENS, ALEXA ANN
Entity type:Individual
Prefix:
First Name:ALEXA
Middle Name:ANN
Last Name:STEPHENS
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:663 SW SPRINGFIELD DR
Mailing Address - Street 2:
Mailing Address - City:ANKENY
Mailing Address - State:IA
Mailing Address - Zip Code:50023-8340
Mailing Address - Country:US
Mailing Address - Phone:515-822-4872
Mailing Address - Fax:
Practice Address - Street 1:2215 15TH AVE APT A1
Practice Address - Street 2:
Practice Address - City:KEARNEY
Practice Address - State:NE
Practice Address - Zip Code:68845-5020
Practice Address - Country:US
Practice Address - Phone:515-822-4872
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-11
Last Update Date:2025-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant