Provider Demographics
NPI:1952383671
Name:STAERKER, DENISE A (CNM)
Entity Type:Individual
Prefix:
First Name:DENISE
Middle Name:A
Last Name:STAERKER
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:13740 CYPRESS TERRACE CIR
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33907-8827
Mailing Address - Country:US
Mailing Address - Phone:239-275-5522
Mailing Address - Fax:239-275-4464
Practice Address - Street 1:1265 VISCAYA PKWY
Practice Address - Street 2:
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33990-3237
Practice Address - Country:US
Practice Address - Phone:239-574-2229
Practice Address - Fax:239-574-2762
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-17
Last Update Date:2009-07-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLARNP1378522367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL301815600Medicaid
FL000011209MOtherHUMANA
FL000011209MOtherHUMANA
FLBQ271ZMedicare PIN
FL301815600Medicaid