Provider Demographics
NPI:1790258739
Name:ESTEP, SIERRA N
Entity Type:Individual
Prefix:
First Name:SIERRA
Middle Name:N
Last Name:ESTEP
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:366 HILLSIDE AVE
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:IN
Mailing Address - Zip Code:46783-8815
Mailing Address - Country:US
Mailing Address - Phone:614-917-9538
Mailing Address - Fax:
Practice Address - Street 1:366 HILLSIDE AVE
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:IN
Practice Address - Zip Code:46783-8815
Practice Address - Country:US
Practice Address - Phone:614-917-9538
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-02
Last Update Date:2019-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer