Provider Demographics
NPI:1790901585
Name:STECK, MARY BETH (FNP)
Entity Type:Individual
Prefix:MRS
First Name:MARY
Middle Name:BETH
Last Name:STECK
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 SUGAR HILL CT
Mailing Address - Street 2:
Mailing Address - City:SIMPSONVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29681-5719
Mailing Address - Country:US
Mailing Address - Phone:864-288-2822
Mailing Address - Fax:
Practice Address - Street 1:700 S PENDLETON ST
Practice Address - Street 2:
Practice Address - City:EASLEY
Practice Address - State:SC
Practice Address - Zip Code:29640-3526
Practice Address - Country:US
Practice Address - Phone:864-855-0643
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1560363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily