Provider Demographics
NPI:1346201860
Name:STECKELBERG, NANCY JANE (NP)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:JANE
Last Name:STECKELBERG
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2355
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98401
Mailing Address - Country:US
Mailing Address - Phone:800-310-4872
Mailing Address - Fax:877-328-4823
Practice Address - Street 1:307 NORTH 46TH STREET
Practice Address - Street 2:SUITE A
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68503
Practice Address - Country:US
Practice Address - Phone:402-466-8259
Practice Address - Fax:402-466-7275
Is Sole Proprietor?:No
Enumeration Date:2006-04-01
Last Update Date:2015-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE28505163W00000X
NE110618363L00000X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No163W00000XNursing Service ProvidersRegistered Nurse
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
Q12621Medicare UPIN
NE277823Medicare ID - Type Unspecified