Provider Demographics
NPI:1881098127
Name:KLEFFNER, STEVEN
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:
Last Name:KLEFFNER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 HIDDEN ACRES DR
Mailing Address - Street 2:
Mailing Address - City:EDWARDSVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62025-7816
Mailing Address - Country:US
Mailing Address - Phone:618-960-9060
Mailing Address - Fax:
Practice Address - Street 1:10 HIDDEN ACRES DR
Practice Address - Street 2:
Practice Address - City:EDWARDSVILLE
Practice Address - State:IL
Practice Address - Zip Code:62025-7816
Practice Address - Country:US
Practice Address - Phone:618-960-9060
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-15
Last Update Date:2014-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO115101163W00000X
IL041.273728163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse