Provider Demographics
NPI:1336751965
Name:STEINKE, KORDINE D
Entity Type:Individual
Prefix:
First Name:KORDINE
Middle Name:D
Last Name:STEINKE
Suffix:
Gender:F
Credentials:
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 287
Mailing Address - Street 2:
Mailing Address - City:MIDWAY
Mailing Address - State:UT
Mailing Address - Zip Code:84049-0287
Mailing Address - Country:US
Mailing Address - Phone:385-250-8459
Mailing Address - Fax:
Practice Address - Street 1:1458 OAK LN
Practice Address - Street 2:
Practice Address - City:MIDWAY
Practice Address - State:UT
Practice Address - Zip Code:84049
Practice Address - Country:US
Practice Address - Phone:385-250-8459
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-17
Last Update Date:2020-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker