Provider Demographics
NPI:1215754445
Name:STEEN, KIRSTEN NICHOLE (PMHNP)
Entity type:Individual
Prefix:
First Name:KIRSTEN
Middle Name:NICHOLE
Last Name:STEEN
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10611 W TREELINE CT
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83713-1861
Mailing Address - Country:US
Mailing Address - Phone:208-515-1602
Mailing Address - Fax:
Practice Address - Street 1:1411 W FRANKLIN ST
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83702-5024
Practice Address - Country:US
Practice Address - Phone:888-224-8250
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-19
Last Update Date:2024-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID1161072363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health