Provider Demographics
NPI:1356790737
Name:STEINKAMP, KENNETH CHARLES (RN)
Entity type:Individual
Prefix:
First Name:KENNETH
Middle Name:CHARLES
Last Name:STEINKAMP
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 1:8916 PINEHURST RD
Mailing Address - Street 2:
Mailing Address - City:WOODBURY
Mailing Address - State:MN
Mailing Address - Zip Code:55125-8828
Mailing Address - Country:US
Mailing Address - Phone:651-216-9843
Mailing Address - Fax:
Practice Address - Street 1:8916 PINEHURST RD
Practice Address - Street 2:
Practice Address - City:WOODBURY
Practice Address - State:MN
Practice Address - Zip Code:55125-8828
Practice Address - Country:US
Practice Address - Phone:651-216-9843
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-07
Last Update Date:2019-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2351294163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse