Healthcare Provider Details

I. General information

NPI: 1477539351
Provider Name (Legal Business Name): THERESA STEARNS C.R.N.A.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/21/2005
Last Update Date: 09/29/2026
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5571 BARTMER AVE.
SAINT LOUIS MO
63112-3406
US

IV. Provider business mailing address

5571 BARTMER AVE.
SAINT LOUIS MO
63112-3406
US

V. Phone/Fax

Practice location:
  • Phone: 314-361-6610
  • Fax: 314-361-7566
Mailing address:
  • Phone: 314-361-6610
  • Fax: 314-361-7566

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number209002738
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: