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NPI Code Detail

MEDICARE: STEPHEN PATRICK ULMER CRNA

MEDICARE:   STEPHEN PATRICK ULMER  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
1367500000XCertified Registered Nurse Anesthetist55230KS

General Provider Information

NPI Number : 1497752661
Entity Type Code : Individual
Provider Name (Legal Business Name) : STEPHEN PATRICK ULMER CRNA
Provider Business Mailing Address
First Line : 109 STEEPLECHASE WAY
Second Line :
City : SOUTHERN PINES
State : NC
Zip : 28387-2959
Country : US
Telephone Number : 910-693-1576
Fax Number :
Provider Business Practice Location Address
First Line : 109 STEEPLECHASE WAY
Second Line :
City : SOUTHERN PINES
State : NC
Zip : 28387-2959
Country : US
Telephone Number : 910-693-1576
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/04/2005
Last Update Date : 09/17/2015

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Directions to “ STEPHEN PATRICK ULMER CRNA” Practice Location

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