Provider Demographics
NPI:1174061204
Name:STEMMERMAN, PAUL (MSN, PMHNP-BC)
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:
Last Name:STEMMERMAN
Suffix:
Gender:M
Credentials:MSN, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 FARRAR DR
Mailing Address - Street 2:SUITE 109
Mailing Address - City:CAPE GIRARDEAU
Mailing Address - State:MO
Mailing Address - Zip Code:63701-4902
Mailing Address - Country:US
Mailing Address - Phone:573-334-7055
Mailing Address - Fax:573-334-7961
Practice Address - Street 1:106 FARRAR DR
Practice Address - Street 2:SUITE 109
Practice Address - City:CAPE GIRARDEAU
Practice Address - State:MO
Practice Address - Zip Code:63701-4902
Practice Address - Country:US
Practice Address - Phone:573-334-7055
Practice Address - Fax:573-334-7961
Is Sole Proprietor?:No
Enumeration Date:2017-02-09
Last Update Date:2017-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2012008791363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health