MEDICARE: HOWARD GLENN STUBBLEFIELD III CRNA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	367500000X	Certified Registered Nurse Anesthetist	041505	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1245309947
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HOWARD GLENN STUBBLEFIELD III CRNA

Provider Business Mailing Address
First Line	:	PO BOX 26580
Second Line	:
City	:	GREENSBORO
State	:	NC
Zip	:	27415-6580
Country	:	US
Telephone Number	:	336-832-7786
Fax Number	:

Provider Business Practice Location Address
First Line	:	501 N ELAM AVE
Second Line	:
City	:	GREENSBORO
State	:	NC
Zip	:	27403-1118
Country	:	US
Telephone Number	:	336-832-1000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/07/2006
Last Update Date	:	04/06/2026

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