Healthcare Provider Details

I. General information

NPI: 1356447189
Provider Name (Legal Business Name): E.DIANE STEEVES ENTERPRISES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/16/2006
Last Update Date: 10/05/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

126 MAIN ST
HALSTEAD KS
67056-1708
US

IV. Provider business mailing address

126 MAIN ST PO BOX 55
HALSTEAD KS
67056-1708
US

V. Phone/Fax

Practice location:
  • Phone: 316-835-3700
  • Fax: 316-835-3701
Mailing address:
  • Phone: 316-835-3700
  • Fax: 316-835-3701

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MS. EUGENIA DIANE STEEVES
Title or Position: PRESIDENT
Credential: RN, ARNP
Phone: 316-835-3700