Provider Demographics
NPI:1578900734
Name:STECKBAUER, CATALINA (MS, RN)
Entity Type:Individual
Prefix:MS
First Name:CATALINA
Middle Name:
Last Name:STECKBAUER
Suffix:
Gender:F
Credentials:MS, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1509 N ARTHUR AVE
Mailing Address - Street 2:
Mailing Address - City:POCATELLO
Mailing Address - State:ID
Mailing Address - Zip Code:83204-2506
Mailing Address - Country:US
Mailing Address - Phone:208-234-7199
Mailing Address - Fax:208-234-8084
Practice Address - Street 1:1509 N ARTHUR AVE
Practice Address - Street 2:
Practice Address - City:POCATELLO
Practice Address - State:ID
Practice Address - Zip Code:83204-2506
Practice Address - Country:US
Practice Address - Phone:208-234-7199
Practice Address - Fax:208-234-8084
Is Sole Proprietor?:No
Enumeration Date:2013-05-29
Last Update Date:2013-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDN-10198163WA2000X, 171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WA2000XNursing Service ProvidersRegistered NurseAdministrator
No171M00000XOther Service ProvidersCase Manager/Care Coordinator