Provider Demographics
NPI:1285375303
Name:STINER, AUBURN E (RN)
Entity type:Individual
Prefix:MRS
First Name:AUBURN
Middle Name:E
Last Name:STINER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:AUBURN
Other - Middle Name:
Other - Last Name:STINER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN
Mailing Address - Street 1:204 E GUDGELL AVE
Mailing Address - Street 2:
Mailing Address - City:INDEPENDENCE
Mailing Address - State:MO
Mailing Address - Zip Code:64055-1442
Mailing Address - Country:US
Mailing Address - Phone:816-682-2513
Mailing Address - Fax:
Practice Address - Street 1:204 E GUDGELL AVE
Practice Address - Street 2:
Practice Address - City:INDEPENDENCE
Practice Address - State:MO
Practice Address - Zip Code:64055-1442
Practice Address - Country:US
Practice Address - Phone:816-682-2513
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-05
Last Update Date:2022-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2013025153163WA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WA0400XNursing Service ProvidersRegistered NurseAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO2013025153Medicaid