=====================================================
General NPI Number Information
=====================================================
NPI Number | 1699733824
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MARY KATHALEEN STEINKE NP
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/04/2006
-----------------------------------------------------
Last Update Date | 03/07/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1600 ALBANY ST SOUTH ENTRANCE GROUND FLOOR
-----------------------------------------------------
City | BEECH GROVE
-----------------------------------------------------
State | IN
-----------------------------------------------------
Zip | 46107-1541
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 317-859-1090
-----------------------------------------------------
Fax | 317-859-3322
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 100
-----------------------------------------------------
City | BEECH GROVE
-----------------------------------------------------
State | IN
-----------------------------------------------------
Zip | 46107-0100
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 317-859-1090
-----------------------------------------------------
Fax | 317-859-3322
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363L00000X
-----------------------------------------------------
Taxonomy Name | Nurse Practitioner
-----------------------------------------------------
License Number | 71000331A
-----------------------------------------------------
License Number State | IN
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 363LA2200X
-----------------------------------------------------
Taxonomy Name | Adult Health Nurse Practitioner
-----------------------------------------------------
License Number | 71000331A
-----------------------------------------------------
License Number State | IN
-----------------------------------------------------