Healthcare Provider Details

I. General information

NPI: 1134329808
Provider Name (Legal Business Name): THERESA MARIE STEELE PSYCHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/20/2007
Last Update Date: 09/30/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14241 GRAND OAKS DRIVE BAXTER COMMUNITY BEHAVIORAL HEALTH HOSPITAL
BAXTER MN
56425
US

IV. Provider business mailing address

14241 GRAND OAKS DRIVE BAXTER COMMUNITY BEHAVIORAL HEALTH HOSPITAL
BAXTER MN
56425
US

V. Phone/Fax

Practice location:
  • Phone: 218-316-3101
  • Fax: 218-829-9141
Mailing address:
  • Phone: 218-316-3101
  • Fax: 218-829-9141

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SP0809X
TaxonomyAdult Psychiatric/Mental Health Clinical Nurse Specialist
License NumberR 104065-8
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: