Healthcare Provider Details

I. General information

NPI: 1851070825
Provider Name (Legal Business Name): STEPHANIE BUERK
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/17/2023
Last Update Date: 04/03/2024
Certification Date: 04/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5880 S HOSPITAL DR
GLOBE AZ
85501-9447
US

IV. Provider business mailing address

295 E HUNTER DR
GLOBE AZ
85501-1522
US

V. Phone/Fax

Practice location:
  • Phone: 928-425-3261
  • Fax:
Mailing address:
  • Phone: 814-594-6561
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number318715
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number149854
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: