Provider Demographics
NPI:1902029556
Name:MITCHELL STEARNS, AMBER REBECCA (DC)
Entity Type:Individual
Prefix:DR
First Name:AMBER
Middle Name:REBECCA
Last Name:MITCHELL STEARNS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:AMBER
Other - Middle Name:R
Other - Last Name:MITCHELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:3952 S FAIRVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65807-4604
Mailing Address - Country:US
Mailing Address - Phone:417-885-9078
Mailing Address - Fax:417-885-9072
Practice Address - Street 1:3952 S FAIRVIEW AVE
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65807-4604
Practice Address - Country:US
Practice Address - Phone:417-885-9078
Practice Address - Fax:417-885-9072
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-11
Last Update Date:2015-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1432111N00000X
MO2007025111111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO1477723229Medicare NSC
MO1902029556Medicare NSC