Provider Demographics
NPI:1891922019
Name:STEINER, MCKENZIE E (NMD)
Entity Type:Individual
Prefix:
First Name:MCKENZIE
Middle Name:E
Last Name:STEINER
Suffix:
Gender:F
Credentials:NMD
Other - Prefix:
Other - First Name:MCKENZIE
Other - Middle Name:E
Other - Last Name:STEINER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:45 SCOTT DR
Mailing Address - Street 2:
Mailing Address - City:VICTOR
Mailing Address - State:ID
Mailing Address - Zip Code:83455-5539
Mailing Address - Country:US
Mailing Address - Phone:307-690-8621
Mailing Address - Fax:
Practice Address - Street 1:45 SCOTT DR
Practice Address - Street 2:
Practice Address - City:VICTOR
Practice Address - State:ID
Practice Address - Zip Code:83455-5539
Practice Address - Country:US
Practice Address - Phone:307-690-8621
Practice Address - Fax:360-794-7236
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-15
Last Update Date:2020-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDNMD-0004175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath