Healthcare Provider Details

I. General information

NPI: 1295288736
Provider Name (Legal Business Name): WHITNEY STEARNS CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/02/2016
Last Update Date: 11/07/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9200 W WISCONSIN AVE
MILWAUKEE WI
53226-3522
US

IV. Provider business mailing address

2716 N SHEPARD AVE
MILWAUKEE WI
53211-3852
US

V. Phone/Fax

Practice location:
  • Phone: 414-777-1013
  • Fax:
Mailing address:
  • Phone: 713-594-7370
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number7106-33
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: