Provider Demographics
NPI:1306019690
Name:STEFFES, LYNN ANN (PT)
Entity Type:Individual
Prefix:
First Name:LYNN
Middle Name:ANN
Last Name:STEFFES
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12660 W CHERRYTREE LN
Mailing Address - Street 2:
Mailing Address - City:NEW BERLIN
Mailing Address - State:WI
Mailing Address - Zip Code:53151-7600
Mailing Address - Country:US
Mailing Address - Phone:414-587-0374
Mailing Address - Fax:414-529-2417
Practice Address - Street 1:12660 W CHERRYTREE LN
Practice Address - Street 2:
Practice Address - City:NEW BERLIN
Practice Address - State:WI
Practice Address - Zip Code:53151-7600
Practice Address - Country:US
Practice Address - Phone:414-587-0374
Practice Address - Fax:414-529-2417
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-08
Last Update Date:2008-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2434-024225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI40053500Medicaid