Healthcare Provider Details

I. General information

NPI: 1124078928
Provider Name (Legal Business Name): STEPHANIE FAYE PATRICK R.N., C.R.N.A.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: STEPHANIE FAYE SAWYERS R.N., C.R.N.A.

II. Dates (important events)

Enumeration Date: 05/11/2006
Last Update Date: 02/04/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4549 RAYNOR COURT OUTPATIENT ANESTHESIA SPECIALISTS
MASON OH
45040
US

IV. Provider business mailing address

PO BOX 807 OUTPATIENT ANESTHESIA SPECIALISTS
MASON OH
45040-0807
US

V. Phone/Fax

Practice location:
  • Phone: 513-204-5696
  • Fax: 877-284-4283
Mailing address:
  • Phone: 513-204-5696
  • Fax: 877-284-4283

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN-286110
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberNA-08698
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: