Healthcare Provider Details

I. General information

NPI: 1851663421
Provider Name (Legal Business Name): MR. STEVEN HOLLISTER TEKELL
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/30/2012
Last Update Date: 11/08/2022
Certification Date: 11/08/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1225 S GEAR AVE
WEST BURLINGTON IA
52655-1691
US

IV. Provider business mailing address

1225 S GEAR AVE
WEST BURLINGTON IA
52655-1691
US

V. Phone/Fax

Practice location:
  • Phone: 319-768-1000
  • Fax:
Mailing address:
  • Phone: 319-768-1000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number16434
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP124908
License Number StateTX
# 3
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberA135664
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: