Provider Demographics
NPI:1174650436
Name:STERBUTZEL, PATRICIA EDGE (CRNA)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:EDGE
Last Name:STERBUTZEL
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:PATRICIA
Other - Middle Name:KAYE
Other - Last Name:HILL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA
Mailing Address - Street 1:384 CENTER SPRINGS RD
Mailing Address - Street 2:
Mailing Address - City:SOMERVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35670-4212
Mailing Address - Country:US
Mailing Address - Phone:256-318-6709
Mailing Address - Fax:
Practice Address - Street 1:8000 AL HIGHWAY 69
Practice Address - Street 2:
Practice Address - City:GUNTERSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35976-7140
Practice Address - Country:US
Practice Address - Phone:256-753-8090
Practice Address - Fax:256-753-8666
Is Sole Proprietor?:No
Enumeration Date:2007-02-27
Last Update Date:2017-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-044761367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL009942694Medicaid
AL51539716OtherBCBS PTAN
AL51539716OtherBCBS PTAN
AL009942694Medicaid