Healthcare Provider Details

I. General information

NPI: 1366909178
Provider Name (Legal Business Name): STEPHANIE DIANNE PINERO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: STEPHANIE DIANNE BARBER CRNA

II. Dates (important events)

Enumeration Date: 02/28/2019
Last Update Date: 07/21/2020
Certification Date: 07/21/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 NEUSE BLVD
NEW BERN NC
28560-3449
US

IV. Provider business mailing address

2000 NEUSE BLVD
NEW BERN NC
28560-3449
US

V. Phone/Fax

Practice location:
  • Phone: 252-633-8111
  • Fax:
Mailing address:
  • Phone: 252-633-8111
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number245741
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: