Provider Demographics
NPI:1720431737
Name:STEFFEN, KATHERINE E (LPN)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:E
Last Name:STEFFEN
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25151 BROOKPARK RD
Mailing Address - Street 2:1908
Mailing Address - City:NORTH OLMSTED
Mailing Address - State:OH
Mailing Address - Zip Code:44070-3471
Mailing Address - Country:US
Mailing Address - Phone:440-214-5664
Mailing Address - Fax:
Practice Address - Street 1:25151 BROOKPARK RD
Practice Address - Street 2:1908
Practice Address - City:NORTH OLMSTED
Practice Address - State:OH
Practice Address - Zip Code:44070-3471
Practice Address - Country:US
Practice Address - Phone:440-214-5664
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-14
Last Update Date:2017-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN062681164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2408166Medicaid