Provider Demographics
NPI:1699733824
Name:STEINKE, MARY KATHALEEN (NP)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:KATHALEEN
Last Name:STEINKE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 100
Mailing Address - Street 2:
Mailing Address - City:BEECH GROVE
Mailing Address - State:IN
Mailing Address - Zip Code:46107-0100
Mailing Address - Country:US
Mailing Address - Phone:317-859-1090
Mailing Address - Fax:317-859-3322
Practice Address - Street 1:1600 ALBANY ST
Practice Address - Street 2:SOUTH ENTRANCE GROUND FLOOR
Practice Address - City:BEECH GROVE
Practice Address - State:IN
Practice Address - Zip Code:46107-1541
Practice Address - Country:US
Practice Address - Phone:317-859-1090
Practice Address - Fax:317-859-3322
Is Sole Proprietor?:No
Enumeration Date:2006-05-04
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71000331A363L00000X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN28078577OtherRN LICENSE
IN000000007697OtherM PLAN
IN000000545416OtherANTHEM
IN11494112OtherCAQH
IN71000331BOtherCSR
IN71000331BOtherCSR
INS59939Medicare UPIN
IN28078577OtherRN LICENSE