1477734184 NPI number — MS. COURTNEY CATHERINE HOLM STEINHAFEL

Table of content: MS. COURTNEY CATHERINE HOLM STEINHAFEL (NPI 1477734184)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1477734184 NPI number — MS. COURTNEY CATHERINE HOLM STEINHAFEL

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
STEINHAFEL
Provider First Name:
COURTNEY
Provider Middle Name:
CATHERINE HOLM
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
HOLM
Provider Other First Name:
COURTNEY
Provider Other Middle Name:
CATHERINE
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1477734184
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/21/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2500 OVERLOOK TER
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MADISON
Provider Business Mailing Address State Name:
WI
Provider Business Mailing Address Postal Code:
53705-2254
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
608-256-1901
Provider Business Mailing Address Fax Number:
608-280-7187

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2500 OVERLOOK TER
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MADISON
Provider Business Practice Location Address State Name:
WI
Provider Business Practice Location Address Postal Code:
53705-2254
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
608-256-1901
Provider Business Practice Location Address Fax Number:
608-280-7187
Provider Enumeration Date:
11/21/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 104100000X , registered in the state of WI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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