Provider Demographics
NPI:1003113432
Name:STEELE, AMY LAUREN (CRNA)
Entity Type:Individual
Prefix:MISS
First Name:AMY
Middle Name:LAUREN
Last Name:STEELE
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:10280 ROAD 185
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:MS
Mailing Address - Zip Code:39350-3957
Mailing Address - Country:US
Mailing Address - Phone:601-562-7993
Mailing Address - Fax:
Practice Address - Street 1:1026 N FLOWOOD DR
Practice Address - Street 2:
Practice Address - City:FLOWOOD
Practice Address - State:MS
Practice Address - Zip Code:39232-9532
Practice Address - Country:US
Practice Address - Phone:601-454-2401
Practice Address - Fax:601-936-9971
Is Sole Proprietor?:No
Enumeration Date:2011-02-21
Last Update Date:2011-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSR862627367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered