Healthcare Provider Details

I. General information

NPI: 1306725064
Provider Name (Legal Business Name): KYLE J STECKER
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/28/2025
Last Update Date: 08/28/2025
Certification Date: 08/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4600 W SCHROEDER DR
BROWN DEER WI
53223-6458
US

IV. Provider business mailing address

10186 STATE ROAD 60
CEDARBURG WI
53012-8917
US

V. Phone/Fax

Practice location:
  • Phone: 414-865-2500
  • Fax:
Mailing address:
  • Phone: 920-889-1385
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number1735033
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: