Provider Demographics
NPI:1790026300
Name:STECKEL, KRYSTAL (PA-C)
Entity type:Individual
Prefix:
First Name:KRYSTAL
Middle Name:
Last Name:STECKEL
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:KRYSTAL
Other - Middle Name:
Other - Last Name:GRAHAM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:1151 S HIGHWAY 160
Mailing Address - Street 2:
Mailing Address - City:PAHRUMP
Mailing Address - State:NV
Mailing Address - Zip Code:89048-4700
Mailing Address - Country:US
Mailing Address - Phone:775-727-8900
Mailing Address - Fax:775-537-2090
Practice Address - Street 1:1151 S HIGHWAY 160
Practice Address - Street 2:
Practice Address - City:PAHRUMP
Practice Address - State:NV
Practice Address - Zip Code:89048
Practice Address - Country:US
Practice Address - Phone:775-727-8900
Practice Address - Fax:775-537-2090
Is Sole Proprietor?:No
Enumeration Date:2013-03-06
Last Update Date:2018-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant