Provider Demographics
NPI:1588918320
Name:STECKSTOR, KATHY LYNNE (RN)
Entity type:Individual
Prefix:MRS
First Name:KATHY
Middle Name:LYNNE
Last Name:STECKSTOR
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:164 BAYWOOD DR
Mailing Address - Street 2:
Mailing Address - City:CHEEKTOWAGA
Mailing Address - State:NY
Mailing Address - Zip Code:14227-2670
Mailing Address - Country:US
Mailing Address - Phone:716-668-2047
Mailing Address - Fax:716-816-1708
Practice Address - Street 1:157 ELK ST
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14210-1419
Practice Address - Country:US
Practice Address - Phone:716-816-4556
Practice Address - Fax:716-816-1708
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-01
Last Update Date:2012-11-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY347303-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse