Provider Demographics
NPI:1487491890
Name:BLUMENSCHEIN-WING, STEPHANIE KATHARINA (RN)
Entity type:Individual
Prefix:MISS
First Name:STEPHANIE
Middle Name:KATHARINA
Last Name:BLUMENSCHEIN-WING
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MRS
Other - First Name:STEPHANIE
Other - Middle Name:KATHARINA
Other - Last Name:WILLIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:2991 HYACINTH ST
Mailing Address - Street 2:
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88007-8078
Mailing Address - Country:US
Mailing Address - Phone:303-880-1942
Mailing Address - Fax:
Practice Address - Street 1:2991 HYACINTH ST
Practice Address - Street 2:
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88007-8078
Practice Address - Country:US
Practice Address - Phone:303-880-1942
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-12
Last Update Date:2024-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM65766163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse