Provider Demographics
NPI:1205015401
Name:STEELE, KENT (PA-C)
Entity type:Individual
Prefix:
First Name:KENT
Middle Name:
Last Name:STEELE
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 258
Mailing Address - Street 2:
Mailing Address - City:DELTA JUNCTION
Mailing Address - State:AK
Mailing Address - Zip Code:99737-0258
Mailing Address - Country:US
Mailing Address - Phone:907-895-6233
Mailing Address - Fax:907-895-6288
Practice Address - Street 1:2730 ALASKA HIGHWAY
Practice Address - Street 2:
Practice Address - City:DELTA JUNCTION
Practice Address - State:AK
Practice Address - Zip Code:99737
Practice Address - Country:US
Practice Address - Phone:907-895-6233
Practice Address - Fax:907-895-6288
Is Sole Proprietor?:No
Enumeration Date:2007-10-24
Last Update Date:2025-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK231363A00000X
AKPADA231363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
AK1020443Medicaid
AKP56057Medicare UPIN