Provider Demographics
NPI:1326417874
Name:STEINHARDT, CRYSTAL M (APNP, FNP)
Entity Type:Individual
Prefix:MRS
First Name:CRYSTAL
Middle Name:M
Last Name:STEINHARDT
Suffix:
Gender:F
Credentials:APNP, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3301 W FOREST HOME AVE
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53215-2843
Mailing Address - Country:US
Mailing Address - Phone:262-241-1022
Mailing Address - Fax:262-241-1030
Practice Address - Street 1:11270 N PORT WASHINGTON RD
Practice Address - Street 2:
Practice Address - City:MEQUON
Practice Address - State:WI
Practice Address - Zip Code:53092-3410
Practice Address - Country:US
Practice Address - Phone:262-241-1022
Practice Address - Fax:262-241-1030
Is Sole Proprietor?:No
Enumeration Date:2015-09-15
Last Update Date:2021-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI6615-33363LF0000X
WI6615363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI100048763Medicaid