Stefek, Jaqueline R

Stefek, Jaqueline R is an individual health care provider with primary practice located at 3704 Fairfax Ave , Farmington NM 87402-4578. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as her primary health care specialty. Stefek, Jaqueline R can be contacted via phone (303) 596-0257.

Contact Information

Primary practice address
3704 Fairfax Ave Farmington NM 87402-4578
Phone: (303) 596-0257
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 163304 Colorado
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X CRNA-01176 New Mexico
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X AC006386 Maryland

Profile Details

NPI number 1750317467
LBN Legal business name Stefek, Jaqueline R
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 24th, 2006
Last updated Jun 26th, 2024 - about 3 months ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1750317467 NPPES
Utah MEDICAID 1750317467
Utah MEDICAID 38278251
Utah MEDICAID 685594
Utah MEDICAID 08259861
Utah MEDICAID 90580834

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