Provider Demographics
NPI:1811481096
Name:STEFFEN FLOOD, LARAE LYNN
Entity type:Individual
Prefix:
First Name:LARAE
Middle Name:LYNN
Last Name:STEFFEN FLOOD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:LARAE
Other - Middle Name:LYNN
Other - Last Name:STEFFEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 1686
Mailing Address - Street 2:
Mailing Address - City:KEARNEY
Mailing Address - State:NE
Mailing Address - Zip Code:68848-1686
Mailing Address - Country:US
Mailing Address - Phone:308-236-0550
Mailing Address - Fax:
Practice Address - Street 1:15 W 22ND ST
Practice Address - Street 2:
Practice Address - City:KEARNEY
Practice Address - State:NE
Practice Address - Zip Code:68847
Practice Address - Country:US
Practice Address - Phone:308-236-0550
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-20
Last Update Date:2018-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator