Provider Demographics
NPI:1245678549
Name:STEINHARDT, SUSAN CAROL (RN)
Entity type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:CAROL
Last Name:STEINHARDT
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:46 S HIAWATHA CIR
Mailing Address - Street 2:
Mailing Address - City:SHEBOYGAN
Mailing Address - State:WI
Mailing Address - Zip Code:53081-7034
Mailing Address - Country:US
Mailing Address - Phone:920-918-1570
Mailing Address - Fax:
Practice Address - Street 1:46 S HIAWATHA CIR
Practice Address - Street 2:
Practice Address - City:SHEBOYGAN
Practice Address - State:WI
Practice Address - Zip Code:53081-7034
Practice Address - Country:US
Practice Address - Phone:920-918-1570
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-07
Last Update Date:2013-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI119832172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker