Basic Information
Provider Information
NPI: 1285964049
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: STERNKE
FirstName: HEATHER
MiddleName: N.
NamePrefix: MRS.
NameSuffix:  
Credential: CRNA
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: MEADOWS
OtherFirstName: HEATHER
OtherMiddleName: N.
OtherNamePrefix: MS.
OtherNameSuffix:  
OtherCredential: DNAP, CRNA
OtherLastNameType: 1
Mailing Information
Address1: PO BOX 845347
Address2:  
City: DALLAS
State: TX
PostalCode: 752845347
CountryCode: US
TelephoneNumber: 2146487833
FaxNumber:  
Practice Location
Address1: 5323 HARRY HINES BLVD
Address2:  
City: DALLAS
State: TX
PostalCode: 753909087
CountryCode: US
TelephoneNumber: 2146487833
FaxNumber:  
Other Information
ProviderEnumerationDate: 12/30/2009
LastUpdateDate: 10/16/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
367500000X675181TXY Physician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered 

No ID Information.


Home