MEDICARE: MARY NICOLE STEINBACH APRN

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	363LF0000X	Family Nurse Practitioner	7327330-4405	UT

General Provider Information

NPI Number	:	1881958189
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARY NICOLE STEINBACH APRN

Provider Business Mailing Address
First Line	:	30 N 1900 E
Second Line	:	ROOM 5C310
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84132-2406
Country	:	US
Telephone Number	:	801-587-4474
Fax Number	:

Provider Business Practice Location Address
First Line	:	30 N 1900 E
Second Line	:	ROOM 5C310
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84132-2406
Country	:	US
Telephone Number	:	801-587-4474
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/02/2012
Last Update Date	:	11/19/2021

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