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General NPI Number Information
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NPI Number | 1356724702
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Entity Type | Individual
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Provider Name | STACEY STEENO CNM
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Gender | Female
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Dates
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Enumeration Date | 07/02/2015
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Last Update Date | 07/14/2022
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Provider Practice Location Address
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Address Line | 2700 BAKER ST
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City | MUSKEGON
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State | MI
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Zip | 49444-2157
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Country | US
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Telephone | 231-737-1335
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Fax |
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Provider Business Mailing Address
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Address Line | 8195 BEL CHERRIE DR
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City | TRAVERSE CITY
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State | MI
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Zip | 49686-1636
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Country | US
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Telephone | 231-590-8006
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 367A00000X
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Taxonomy Name | Advanced Practice Midwife
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License Number | 4704239783
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License Number State | MI
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