MEDICARE: ELISA MARIE STERNER PA-C

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	363A00000X	Physician Assistant	10000627A	IN

General Provider Information

NPI Number	:	1881806586
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELISA MARIE STERNER PA-C

Provider Business Mailing Address
First Line	:	10995 ALLISONVILLE RD
Second Line	:	SUITE 100
City	:	FISHERS
State	:	IN
Zip	:	46038-2616
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	10995 ALLISONVILLE RD
Second Line	:
City	:	FISHERS
State	:	IN
Zip	:	46038-2616
Country	:	US
Telephone Number	:	317-842-7928
Fax Number	:

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

Provider Enumeration Date	:	05/04/2007
Last Update Date	:	01/02/2008

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