Provider Demographics
NPI:1326870403
Name:STRAUB, STEFFENI LYNN (AGACNP-BC)
Entity type:Individual
Prefix:
First Name:STEFFENI
Middle Name:LYNN
Last Name:STRAUB
Suffix:
Gender:F
Credentials:AGACNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3100 COOPER ST
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MI
Mailing Address - Zip Code:49201-7545
Mailing Address - Country:US
Mailing Address - Phone:517-780-6157
Mailing Address - Fax:
Practice Address - Street 1:3100 COOPER ST
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MI
Practice Address - Zip Code:49201-7545
Practice Address - Country:US
Practice Address - Phone:517-780-6157
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-16
Last Update Date:2024-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704338682363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner