Provider Demographics
NPI:1568043677
Name:STIRN, CARRIE ANNE
Entity type:Individual
Prefix:
First Name:CARRIE
Middle Name:ANNE
Last Name:STIRN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:602 W HIGH ST
Mailing Address - Street 2:
Mailing Address - City:LIBERTY
Mailing Address - State:IN
Mailing Address - Zip Code:47353-8469
Mailing Address - Country:US
Mailing Address - Phone:765-967-7858
Mailing Address - Fax:
Practice Address - Street 1:3021 VERNON PL STE 2
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45219-2417
Practice Address - Country:US
Practice Address - Phone:513-541-7099
Practice Address - Fax:513-541-0989
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-20
Last Update Date:2021-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHLE-00035956363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily