Provider Demographics
NPI:1477822518
Name:STEFFEN, AMY LYNN (CPNP)
Entity Type:Individual
Prefix:MS
First Name:AMY
Middle Name:LYNN
Last Name:STEFFEN
Suffix:
Gender:F
Credentials:CPNP
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Mailing Address - Street 1:17705 HUTCHINS DR STE 250
Mailing Address - Street 2:
Mailing Address - City:MINNETONKA
Mailing Address - State:MN
Mailing Address - Zip Code:55345-4103
Mailing Address - Country:US
Mailing Address - Phone:952-401-8300
Mailing Address - Fax:952-401-8242
Practice Address - Street 1:111 HUNDERTMARK RD STE 210
Practice Address - Street 2:
Practice Address - City:CHASKA
Practice Address - State:MN
Practice Address - Zip Code:55318-1196
Practice Address - Country:US
Practice Address - Phone:952-401-8300
Practice Address - Fax:952-401-8242
Is Sole Proprietor?:No
Enumeration Date:2011-12-19
Last Update Date:2022-01-20
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Provider Licenses
StateLicense IDTaxonomies
MN154976-4363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN154976-4Medicaid
MN154976-4Medicaid