Healthcare Provider Details

I. General information

NPI: 1144413972
Provider Name (Legal Business Name): LAURA W STEKETEE RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/24/2007
Last Update Date: 08/24/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2825 RED OAK DR
BEND OR
97701-8344
US

IV. Provider business mailing address

760 NW 67TH ST
REDMOND OR
97756-9386
US

V. Phone/Fax

Practice location:
  • Phone: 541-317-5059
  • Fax:
Mailing address:
  • Phone: 541-923-5233
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License Number
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: