Provider Demographics
NPI:1083235592
Name:STEPP, JENNIFER MICHELLE BERG (MD)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:MICHELLE BERG
Last Name:STEPP
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:MICHELLE
Other - Last Name:BERG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:17487 S HEALTHCARE DR
Mailing Address - Street 2:
Mailing Address - City:LAVEEN
Mailing Address - State:AZ
Mailing Address - Zip Code:85339-8500
Mailing Address - Country:US
Mailing Address - Phone:520-550-6000
Mailing Address - Fax:520-550-6027
Practice Address - Street 1:17487 S HEALTHCARE DR
Practice Address - Street 2:
Practice Address - City:LAVEEN
Practice Address - State:AZ
Practice Address - Zip Code:85339-8500
Practice Address - Country:US
Practice Address - Phone:520-694-8888
Practice Address - Fax:520-694-1640
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-06
Last Update Date:2023-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ68123207Q00000X
AZR77940207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine