Healthcare Provider Details

I. General information

NPI: 1366624165
Provider Name (Legal Business Name): SHARON KAY STEELE LPN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/04/2007
Last Update Date: 12/04/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1510 HIGHWAY JJ LOT41
MOBERLY MO
65270
US

IV. Provider business mailing address

1510 HIGHWAY JJ LOT 41
MOBERLY MO
65270
US

V. Phone/Fax

Practice location:
  • Phone: 660-263-1539
  • Fax:
Mailing address:
  • Phone: 660-263-1539
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code286500000X
TaxonomyMilitary Hospital
License NumberPN043533
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: