Provider Demographics
NPI:1407919475
Name:STEINHOFF, DOTTIE L (PA)
Entity Type:Individual
Prefix:
First Name:DOTTIE
Middle Name:L
Last Name:STEINHOFF
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5400 GIBSON BLVD SE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87108-4729
Mailing Address - Country:US
Mailing Address - Phone:505-262-7960
Mailing Address - Fax:505-232-1368
Practice Address - Street 1:17100 PALE ANEMONE ST
Practice Address - Street 2:
Practice Address - City:PARKER
Practice Address - State:CO
Practice Address - Zip Code:80134-4391
Practice Address - Country:US
Practice Address - Phone:205-775-2517
Practice Address - Fax:720-780-7057
Is Sole Proprietor?:No
Enumeration Date:2006-12-19
Last Update Date:2021-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMPA2013-0047363A00000X
COPA0005959363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NMPA2013-0047OtherNEW MEXICO MEDICAL LICENSE
TXQ78857Medicare UPIN
TX8L21742Medicare PIN
TX8L21741Medicare PIN
TX8L21793Medicare PIN
TXPA04989OtherTX LICENSE