MEDICARE: KATHY STEARNS CRNA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	367500000X	Certified Registered Nurse Anesthetist	ARNP2986042	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	G3164	OTHER	FL	BCBS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1144276171
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHY STEARNS CRNA

Provider Business Mailing Address
First Line	:	320 LARGOVISTA DR
Second Line	:
City	:	OAKLAND
State	:	FL
Zip	:	34787-8979
Country	:	US
Telephone Number	:	321-217-6938
Fax Number	:

Provider Business Practice Location Address
First Line	:	320 LARGOVISTA DR
Second Line	:
City	:	OAKLAND
State	:	FL
Zip	:	34787-8979
Country	:	US
Telephone Number	:	321-217-6938
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/25/2006
Last Update Date	:	11/29/2007

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