Provider Demographics
NPI:1215332697
Name:STEIGENGA, ANNICE HUNTER (COTA)
Entity type:Individual
Prefix:
First Name:ANNICE
Middle Name:HUNTER
Last Name:STEIGENGA
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11303 GRAND OAK DR
Mailing Address - Street 2:APT #10
Mailing Address - City:GRAND BLANC
Mailing Address - State:MI
Mailing Address - Zip Code:48439-1254
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:11303 GRAND OAK DR
Practice Address - Street 2:APT #10
Practice Address - City:GRAND BLANC
Practice Address - State:MI
Practice Address - Zip Code:48439-1254
Practice Address - Country:US
Practice Address - Phone:616-432-0755
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-28
Last Update Date:2014-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI8482OtherSUB ACUTE REHAB