Basic Information
Provider Information
NPI: 1538281308
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: STEARNS
FirstName: JANET
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: H.I.S.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 6700 WASHINGTON AVE S
Address2:  
City: EDEN PRAIRIE
State: MN
PostalCode: 553443405
CountryCode: US
TelephoneNumber: 6123511529
FaxNumber:  
Practice Location
Address1: 1006 JUNCTION HWY STE 1
Address2:  
City: KERRVILLE
State: TX
PostalCode: 78028
CountryCode: US
TelephoneNumber: 8308951020
FaxNumber: 8307923053
Other Information
ProviderEnumerationDate: 04/04/2007
LastUpdateDate: 02/20/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
237600000X TXN Speech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter 
237700000X50701TXY Speech, Language and Hearing Service ProvidersHearing Instrument Specialist 

ID Information
IDTypeStateIssuerDescription
1775520-0105TX MEDICAID


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