MEDICARE: E. DIANE STEEVES ENTERPRISES, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QP2300X	Primary Care Clinic/Center	44254	KS

General Provider Information

NPI Number	:	1346332996
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	E. DIANE STEEVES ENTERPRISES, INC.

Provider Business Mailing Address
First Line	:	328 POPLAR AVE
Second Line	:
City	:	HALSTEAD
State	:	KS
Zip	:	67056-2014
Country	:	US
Telephone Number	:	316-835-3336
Fax Number	:	316-835-3701

Provider Business Practice Location Address
First Line	:	328 POPLAR AVE.
Second Line	:
City	:	HALSTEAD
State	:	KS
Zip	:	67056-2014
Country	:	US
Telephone Number	:	316-835-3336
Fax Number	:	316-835-3701

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MS. EUGENIA DIANE STEEVES
Credential	:	NP
Telephone Number	:	316-835-3336

Provider Enumeration Date	:	09/29/2006
Last Update Date	:	07/21/2022

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