Provider Demographics
NPI:1922655158
Name:STEEN, KATELYN JO (OD)
Entity Type:Individual
Prefix:
First Name:KATELYN
Middle Name:JO
Last Name:STEEN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:13330 WASHINGTON AVE STE 300
Mailing Address - Street 2:
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:WI
Mailing Address - Zip Code:53177-1297
Mailing Address - Country:US
Mailing Address - Phone:262-267-8161
Mailing Address - Fax:262-267-8162
Practice Address - Street 1:13330 WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:MOUNT PLEASANT
Practice Address - State:WI
Practice Address - Zip Code:53177-1297
Practice Address - Country:US
Practice Address - Phone:262-267-8161
Practice Address - Fax:262-267-8162
Is Sole Proprietor?:No
Enumeration Date:2019-08-22
Last Update Date:2023-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL046.011368152W00000X
WI359535152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist