Provider Demographics
NPI:1902206899
Name:STEENSMA, KATHLEEN E (FNP-C)
Entity Type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:E
Last Name:STEENSMA
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:KATHLEEN
Other - Middle Name:E
Other - Last Name:CHRISTIE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:15700 37TH AVE N. #110
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55446
Mailing Address - Country:US
Mailing Address - Phone:763-577-0008
Mailing Address - Fax:763-577-0027
Practice Address - Street 1:15700 37TH AVE N. #110
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:MN
Practice Address - Zip Code:55446
Practice Address - Country:US
Practice Address - Phone:763-577-0008
Practice Address - Fax:763-577-0027
Is Sole Proprietor?:No
Enumeration Date:2014-08-27
Last Update Date:2019-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2014023981363LF0000X
MN6184-NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily