Provider Demographics
NPI:1790419547
Name:STEFFEN, KOREY (PHARMD, RPH)
Entity Type:Individual
Prefix:DR
First Name:KOREY
Middle Name:
Last Name:STEFFEN
Suffix:
Gender:M
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3322 AVENUE I
Mailing Address - Street 2:
Mailing Address - City:SCOTTSBLUFF
Mailing Address - State:NE
Mailing Address - Zip Code:69361-4589
Mailing Address - Country:US
Mailing Address - Phone:308-632-3767
Mailing Address - Fax:
Practice Address - Street 1:3322 AVENUE I
Practice Address - Street 2:
Practice Address - City:SCOTTSBLUFF
Practice Address - State:NE
Practice Address - Zip Code:69361-4589
Practice Address - Country:US
Practice Address - Phone:308-632-3767
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-15
Last Update Date:2022-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE17517183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist