Provider Demographics
NPI:1952660896
Name:STEFFENS, KEVIN (RN)
Entity Type:Individual
Prefix:
First Name:KEVIN
Middle Name:
Last Name:STEFFENS
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:75 LIVINGSTON ST APT PH
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11201-5088
Mailing Address - Country:US
Mailing Address - Phone:718-522-5948
Mailing Address - Fax:
Practice Address - Street 1:57 WILLOUGHBY ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11201-5257
Practice Address - Country:US
Practice Address - Phone:718-907-6248
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-13
Last Update Date:2012-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY585188163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse