MEDICARE: STEPHANIE A STIEBEN PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	15-00986	KS

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1932209152
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEPHANIE A STIEBEN PA

Provider Business Mailing Address
First Line	:	1100 N MAIN ST
Second Line	:
City	:	HUTCHINSON
State	:	KS
Zip	:	67501-4406
Country	:	US
Telephone Number	:	620-669-6690
Fax Number	:	620-694-4528

Provider Business Practice Location Address
First Line	:	1125 N MAIN ST
Second Line	:
City	:	HUTCHINSON
State	:	KS
Zip	:	67501-4405
Country	:	US
Telephone Number	:	620-669-6690
Fax Number	:	620-694-4528

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/25/2006
Last Update Date	:	05/23/2008

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Directions to “ STEPHANIE A STIEBEN PA” Practice Location

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