Healthcare Provider Details
I. General information
NPI: 1164081733
Provider Name (Legal Business Name): MS. KAREN M STEFFES
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 06/07/2019
Last Update Date: 07/23/2019
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
35900 EUCLID AVE
WILLOUGHBY OH
44094-4623
US
IV. Provider business mailing address
1230 BELROSE RD
MAYFIELD HEIGHTS OH
44124-1529
US
V. Phone/Fax
- Phone: 440-953-3000
- Fax:
- Phone: 440-241-1255
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163WP0808X |
| Taxonomy | Psychiatric/Mental Health Registered Nurse |
| License Number | RN410709 |
| License Number State | OH |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LP0808X |
| Taxonomy | Psychiatric/Mental Health Nurse Practitioner |
| License Number | APRN.CNP.025235 |
| License Number State | OH |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: