STEPHANIE R REVORD (NPI# 1174992846) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174992846 |
| Entity Type | Individual |
| Full Name | STEPHANIE R REVORD |
| Other Name | STEPHANIE R LEE |
| Credential | APRN |
| Practice Address |
201 Ridge St Ste 312 Council Bluffs IA 51503-4643 |
| Mailing Address |
Po Box 3755 Omaha NE 68103-0755 |
| Practice Telephone | 7123967880 |
| Practice Fax Number | 7123967885 |
| Mailing Telephone | 4023542100 |
| Mailing Fax Number | 4023542155 |
| Enumeration Date | 2015-09-23 |
| Last Update Date | 2019-07-03 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | F141666 | IA | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LW0102X |
Nurse Practitioner Specialization: Women's Health |
F141666 | IA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NE | 10026480117 | 05 | |
| NE | 10026211300 | 05 | |
| IA | 1174992846 | 05 |
| Street Address |
201 RIDGE ST STE 312 |
| City | COUNCIL BLUFFS |
| State | IA |
| Zip Code | 51503-4643 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245205202 | Erik N Schulte | Obstetrics & Gynecology | 201 Ridge St Ste 312, Council Bluffs, IA 51503-4643 | 2006-02-22 |
| 1437523479 | Desiree M Hericks | Advanced Practice Midwife | 201 Ridge St Ste 312, Council Bluffs, IA 51503-4643 | 2015-11-13 |
| 1396123253 | Rebecca A Leaders | Nurse Practitioner | 201 Ridge St Ste 312, Council Bluffs, IA 51503-4643 | 2015-05-12 |
| 1942696901 | Tana Friesth Perry | Obstetrics & Gynecology | 201 Ridge St Ste 312, Council Bluffs, IA 51503-4643 | 2015-04-07 |
| 1366770489 | Melissa Ruth Hynek | Nurse Practitioner | 201 Ridge St Ste 312, Council Bluffs, IA 51503-4643 | 2009-12-01 |
| 1750492393 | Norman E Ferrer | Obstetrics & Gynecology | 201 Ridge St Ste 312, Council Bluffs, IA 51503-4643 | 2006-08-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326654377 | Michael Menendez | Counselor | N 6th Street and Ave E, Council Bluffs, IA 51503 | 2020-09-16 |
| 1417598301 | Katherine E Turner | Counselor | 2303 Butler Street, Council Bluffs, IA 51503 | 2019-10-02 |
| 1992354666 | Phs Council Bluffs, Inc | Skilled Nursing Facility | 16 Valley View Drive, Council Bluffs, IA 51503 | 2019-09-05 |
| 1629429451 | Nathan Charles Shumway | Podiatrist | 320 Mckenzie Ave Ste 102, Council Bluffs, IA 51503 | 2016-06-22 |
| 1699131797 | Bluffs Pain Management LLC | Pain Medicine | 201 Ridge St Suite 102, Council Bluffs, IA 51503 | 2016-01-06 |
| 1811246903 | Georgia Ann Boeck | Hearing Instrument Specialist | 900 Woodbury Avenue, Suite 8b, Council Bluffs, IA 51503 | 2012-09-05 |
| 1790055796 | Wendy Jane'e Zenor | Licensed Practical Nurse | 1525 Rolling Hills Loop, Council Bluffs, IA 51503 | 2012-01-06 |
| 1649579186 | Mohana K Loya | Internal Medicine | 933 E Pierce St., Council Bluffs, IA 51503 | 2011-03-23 |
| 1568761369 | Brenda Kay Sennett | Occupational Therapist | 1600 Mcpherson Avenue, Council Bluffs, IA 51503 | 2011-03-18 |
| 1710129671 | Heart Lung and Vascular Surgery PC | Specialist | 210 Ridge, Jennie Edmundsen Hospital, Council Bluffs, IA 51503 | 2009-03-24 |
| Find all providers in zip 51503 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659925600 | Emily L Maass | Nurse Practitioner | 800 Mercy Dr Ste 210, Council Bluffs, IA 51503-3128 | 2019-07-29 |
| 1346851656 | Rachel M Kraniewski | Nurse Practitioner | 1 Edmundson Pl Ste 306, Council Bluffs, IA 51503-4620 | 2020-08-11 |
| 1306455506 | Mariah C. Schaaf | Nurse Practitioner | 933 E Pierce St, Council Bluffs, IA 51503-4626 | 2020-07-24 |
| 1821554007 | Alexandria A Leu | Nurse Practitioner | 1 Edmundson Pl, Council Bluffs, IA 51503-4658 | 2019-02-13 |
| 1194295907 | Jami Jo Dowell | Nurse Practitioner | 3502 Metro Dr, Council Bluffs, IA 51501-7761 | 2018-12-05 |
| 1205336740 | Monica E. Wilcox | Nurse Practitioner | 933 E Pierce St, Council Bluffs, IA 51503-4626 | 2018-02-20 |
| 1114425592 | Cross Therapy Center Pllc | Nurse Practitioner | 20 Frank St, Council Bluffs, IA 51503-4460 | 2018-01-31 |
| 1578072351 | Lisa A. Pape | Nurse Practitioner | 933 E Pierce St, Council Bluffs, IA 51503-4626 | 2017-09-25 |
| 1336523893 | Convenient Care Medical Group, Pllc | Nurse Practitioner | 3502 Metro Drive, Suite 200, Council Bluffs, IA 51501-7724 | 2015-07-15 |
| 1396123253 | Rebecca A Leaders | Nurse Practitioner | 201 Ridge St Ste 312, Council Bluffs, IA 51503-4643 | 2015-05-12 |
| Find all providers in COUNCIL BLUFFS | ||||
| City | COUNCIL BLUFFS |
| Zip Code | 51503 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.