Individual
HEATHER DIANNE STELLING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3216 FERGUSON RD, JOPLIN, MO 64804-4033
(417) 208-9034
(417) 313-1275
Mailing address
3216 FERGUSON RD, JOPLIN, MO 64804-4033
(417) 208-9034
(417) 313-1275
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
108124
MO
207LA0401X
Addiction Medicine (Anesthesiology) Physician
108124
MO
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
108124
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
050075597
RAILROAD MEDICARE
—
05
—
100185100B
—
OK
05
—
100364780B
—
KS
01
—
108602A
BCBS
MO
05
—
208624320
—
MO
Enumeration date
03/07/2006
Last updated
02/09/2022
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