Healthcare Provider Details

I. General information

NPI: 1578950846
Provider Name (Legal Business Name): DANIELLE ELIZABETH STENGER CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MISS DANIELLE ELIZABETH RETALLICK

II. Dates (important events)

Enumeration Date: 04/23/2015
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1102 ST. MARYS ROAD ROOM 1204
JUNCTION CITY KS
66441-4139
US

IV. Provider business mailing address

1102 SAINT MARYS RD RM 1204
JUNCTION CITY KS
66441-4139
US

V. Phone/Fax

Practice location:
  • Phone: 785-762-3416
  • Fax: 785-762-3516
Mailing address:
  • Phone: 785-762-3416
  • Fax: 785-762-3516

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number53-85545
License Number StateKS
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number557383
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: