Provider Demographics
NPI:1356596084
Name:STEINHAUS, LAUREL A (FNP-BC)
Entity type:Individual
Prefix:MS
First Name:LAUREL
Middle Name:A
Last Name:STEINHAUS
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1338 W FOREST MEADOWS ST
Mailing Address - Street 2:SUITE 140
Mailing Address - City:FLAGSTAFF
Mailing Address - State:AZ
Mailing Address - Zip Code:86001-7218
Mailing Address - Country:US
Mailing Address - Phone:928-213-8631
Mailing Address - Fax:928-213-8632
Practice Address - Street 1:1338 W FOREST MEADOWS ST
Practice Address - Street 2:SUITE 140
Practice Address - City:FLAGSTAFF
Practice Address - State:AZ
Practice Address - Zip Code:86001-7218
Practice Address - Country:US
Practice Address - Phone:928-213-8631
Practice Address - Fax:928-213-8632
Is Sole Proprietor?:No
Enumeration Date:2008-11-21
Last Update Date:2013-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN094907163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ550302Medicaid
AZ550302Medicaid