Individual
MS. STEFANY MCMULLEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
5230 EOLA DR NW, SALEM, OR 97304-3355
(661) 699-4532
Mailing address
5230 EOLA DR NW, SALEM, OR 97304-3355
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
201608320CRNA-PP
OR
390200000X
Student in an Organized Health Care Education/Training Program
200843420RN
OR
Other
Enumeration date
07/22/2016
Last updated
11/14/2016
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