Provider Demographics
NPI:1740960848
Name:STEFFEN, RAEF RUSSELL (BS, AS)
Entity type:Individual
Prefix:MR
First Name:RAEF
Middle Name:RUSSELL
Last Name:STEFFEN
Suffix:
Gender:M
Credentials:BS, AS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:9429 GERTRUDE ST
Mailing Address - Street 2:
Mailing Address - City:LA VISTA
Mailing Address - State:NE
Mailing Address - Zip Code:68128-4279
Mailing Address - Country:US
Mailing Address - Phone:402-881-6113
Mailing Address - Fax:
Practice Address - Street 1:140 S 77TH ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68114-4577
Practice Address - Country:US
Practice Address - Phone:402-934-4535
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-24
Last Update Date:2023-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE2064225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant