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NPI Code Detail

MEDICARE: SUSAN ELAINE STERN CRNP

MEDICARE: SUSAN ELAINE STERN CRNP
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
1363LW0102XWomen's Health Nurse PractitionerTP001935GPA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
150071427OTHERPACAPITAL BLUE CROSS

General Provider Information

NPI Number : 1740498229
Entity Type Code : Individual
Provider Name (Legal Business Name) : SUSAN ELAINE STERN CRNP
Provider Business Mailing Address
First Line : RD 2 BOX 238
Second Line :
City : MARTINSBURG
State : PA
Zip : 16662
Country : US
Telephone Number : 814-793-3290
Fax Number :
Provider Business Practice Location Address
First Line : 2918 6TH AVE
Second Line :
City : ALTOONA
State : PA
Zip : 16602-1917
Country : US
Telephone Number : 814-944-6055
Fax Number : 814-944-1912
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/18/2007
Last Update Date : 12/13/2007

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Directions to “ SUSAN ELAINE STERN CRNP” Practice Location

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