Healthcare Provider Details

I. General information

NPI: 1427321751
Provider Name (Legal Business Name): KIMBERLY JEANNE STERNER R.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/16/2012
Last Update Date: 02/16/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10180 SE SUNNYSIDE RD
CLACKAMAS OR
97015-8970
US

IV. Provider business mailing address

16469 NW CHARLAIS ST
BEAVERTON OR
97006-7234
US

V. Phone/Fax

Practice location:
  • Phone: 503-571-9240
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number20114351BRN
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: