Provider Demographics
NPI:1144428343
Name:STEELE-PRIDEMORE, EARLENE CLAIRE (CNP)
Entity Type:Individual
Prefix:MRS
First Name:EARLENE
Middle Name:CLAIRE
Last Name:STEELE-PRIDEMORE
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:235 N BREIEL BLVD
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:OH
Mailing Address - Zip Code:45042-3807
Mailing Address - Country:US
Mailing Address - Phone:513-423-0504
Mailing Address - Fax:513-423-9536
Practice Address - Street 1:235 N BREIEL BLVD
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:OH
Practice Address - Zip Code:45042-3807
Practice Address - Country:US
Practice Address - Phone:513-423-0504
Practice Address - Fax:513-423-9536
Is Sole Proprietor?:No
Enumeration Date:2007-07-10
Last Update Date:2007-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN210915363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner