Provider Demographics
NPI:1497905376
Name:STEINBERGER, PAMELA LEE (NP)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:LEE
Last Name:STEINBERGER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:PAMELA
Other - Middle Name:L
Other - Last Name:DODT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1025 MICHIGAN AVENUE
Mailing Address - Street 2:SUITE LL15
Mailing Address - City:LOGANSPORT
Mailing Address - State:IN
Mailing Address - Zip Code:46947-1595
Mailing Address - Country:US
Mailing Address - Phone:574-753-1739
Mailing Address - Fax:574-753-1549
Practice Address - Street 1:1025 MICHIGAN AVE
Practice Address - Street 2:SUITE LL15
Practice Address - City:LOGANSPORT
Practice Address - State:IN
Practice Address - Zip Code:46947-1593
Practice Address - Country:US
Practice Address - Phone:574-753-1739
Practice Address - Fax:574-753-1549
Is Sole Proprietor?:No
Enumeration Date:2008-09-26
Last Update Date:2009-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71002645A363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000588719OtherANTHEM
IN200921710Medicaid
IN200921710Medicaid
IN256170GMedicare PIN