Provider Demographics
NPI:1649784984
Name:STEELE, DEMETRIUS (FAMILY NURSE PRACTIT)
Entity type:Individual
Prefix:
First Name:DEMETRIUS
Middle Name:
Last Name:STEELE
Suffix:
Gender:M
Credentials:FAMILY NURSE PRACTIT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:306 CHAUDRON ST
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:36037-3106
Mailing Address - Country:US
Mailing Address - Phone:334-437-1141
Mailing Address - Fax:
Practice Address - Street 1:4258 US HIGHWAY 80 W
Practice Address - Street 2:
Practice Address - City:SELMA
Practice Address - State:AL
Practice Address - Zip Code:36701-2202
Practice Address - Country:US
Practice Address - Phone:334-874-8800
Practice Address - Fax:334-874-7700
Is Sole Proprietor?:No
Enumeration Date:2017-11-22
Last Update Date:2019-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN273998363LF0000X
AL1-103117363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily