Stephen William Boffemmyer, CRNA
Individual provider Active NPI Certified Registered Nurse Anesthetist · Rutherfordton, NC
NPI 1063554194 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1063554194
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Certified Registered Nurse Anesthetist 367500000X
- License
- 111111 (NC)
- Practice address
- 132 Seven Oaks LN
Rutherfordton, NC 28139-9270 - Phone
- (828) 286-8272
- NPI assigned
- Feb 13, 2007
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 111111 | NC | MD | Pediatric Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rutherford Hospital Inc | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | 111111 | NC | Yes |
Addresses
Primary practice location
132 Seven Oaks LN
Rutherfordton, NC 28139-9270
Mailing address
132 Seven Oaks LN
Rutherfordton, NC 28139-9270
Phone (828) 286-8272
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1111 | Other | NC | BCBS |
Other providers in Rutherfordton, NC
- Hannah Bennett Beam
- Best Care Home Care LLC
- David Clayton Billue
- Blanton Miller DDS PA
- Samuel Eugene Blanton
- Thomas Vance Bolling
- Charles Dana Bond
- Dawn Godfrey Bostic
- Sydna Elizabeth Bougere
- Wesley Scott Braden
All providers in Rutherfordton, NC · Certified Registered Nurse Anesthetist in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.