Healthcare Provider Details

I. General information

NPI: 1366170995
Provider Name (Legal Business Name): PAIGE KATHARINE STIENEKE CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/11/2022
Last Update Date: 08/12/2025
Certification Date: 08/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

BRIAN D. ALLGOOD ARMY COMMUNITY HOSPITAL USAG-HUMPHREYS BLDG # 3030, UNIT 15245
APO AP
96271-5245
US

IV. Provider business mailing address

BRIAN D. ALLGOOD ARMY COMMUNITY HOSPITAL BLDG #3031, UNIT 15245
APO AP
96271-5245
US

V. Phone/Fax

Practice location:
  • Phone: 315-737-1411
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberAP61661204
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberCR001118
License Number StateSD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: