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General NPI Number Information
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NPI Number | 1851343123
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Entity Type | Individual
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Provider Name | STEPHEN P FERNAU APRN, CRNA
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Gender | Male
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Dates
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Enumeration Date | 05/16/2006
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Last Update Date | 01/05/2025
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Provider Practice Location Address
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Address Line | 1625 N CAMPBELL AVE
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City | TUCSON
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State | AZ
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Zip | 85719-4330
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Country | US
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Telephone | 520-694-0111
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Fax |
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Provider Business Mailing Address
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Address Line | 6635 FAWN PATH LN
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City | CASTLE PINES
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State | CO
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Zip | 80108-9623
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Country | US
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Telephone | 630-809-9321
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 141905030
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 041313248
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 209-005622
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License Number State | IL
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