Provider Demographics
NPI:1134481690
Name:STEINER, KENNETH KEITH
Entity Type:Individual
Prefix:
First Name:KENNETH
Middle Name:KEITH
Last Name:STEINER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13349 J B WILLIAMS RD
Mailing Address - Street 2:
Mailing Address - City:LOXLEY
Mailing Address - State:AL
Mailing Address - Zip Code:36551-4005
Mailing Address - Country:US
Mailing Address - Phone:251-223-2328
Mailing Address - Fax:
Practice Address - Street 1:4218 US HIGHWAY 31 S
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:AL
Practice Address - Zip Code:35603-5039
Practice Address - Country:US
Practice Address - Phone:256-560-2237
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-11
Last Update Date:2012-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-042421163WA2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WA2000XNursing Service ProvidersRegistered NurseAdministrator