MEDICARE: MS. MILISA JUNE VAN STEENIS

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	171M00000X	Case Manager/Care Coordinator
2	172V00000X	Community Health Worker

General Provider Information

NPI Number	:	1952079519
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MILISA JUNE VAN STEENIS

Provider Business Mailing Address
First Line	:	326 S WARREN AVE
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43204-3058
Country	:	US
Telephone Number	:	614-374-2215
Fax Number	:

Provider Business Practice Location Address
First Line	:	326 S WARREN AVE
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43204-3058
Country	:	US
Telephone Number	:	614-374-2215
Fax Number	:

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

Provider Enumeration Date	:	08/31/2021
Last Update Date	:	08/14/2024

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