Healthcare Provider Details

I. General information

NPI: 1760658298
Provider Name (Legal Business Name): KATHRYN ANN STEELE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/05/2008
Last Update Date: 05/05/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3101 N FLORIDA AVE
ALAMOGORDO NM
88310-9713
US

IV. Provider business mailing address

3300 EAGLE RIDGE DR
LAS CRUCES NM
88012-7706
US

V. Phone/Fax

Practice location:
  • Phone: 575-434-0033
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License NumberA-273
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: