Provider Demographics
NPI:1982602751
Name:STEEGE, TERRY L (NP)
Entity Type:Individual
Prefix:
First Name:TERRY
Middle Name:L
Last Name:STEEGE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:TERRY
Other - Middle Name:L
Other - Last Name:WENNERSTEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:N10565 GRANDVIEW LANE
Mailing Address - Street 2:
Mailing Address - City:IRONWOOD
Mailing Address - State:MI
Mailing Address - Zip Code:49938-9622
Mailing Address - Country:US
Mailing Address - Phone:906-932-1500
Mailing Address - Fax:906-932-5091
Practice Address - Street 1:N10565 GRANDVIEW LANE
Practice Address - Street 2:
Practice Address - City:IRONWOOD
Practice Address - State:MI
Practice Address - Zip Code:49938-9622
Practice Address - Country:US
Practice Address - Phone:906-932-1500
Practice Address - Fax:906-932-5091
Is Sole Proprietor?:No
Enumeration Date:2005-07-14
Last Update Date:2010-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704148492363LW0102X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
1029609OtherPREFERREDONE
MI4354089Medicaid
MN12D89WEOtherBCBS
WI43901600Medicaid
MI50-0-87-5391-0OtherBCBS
MI500875391OtherBCBS
160033702Medicare PIN
WI0013Medicare PIN
MN12D89WEOtherBCBS
MI50-0-87-5391-0OtherBCBS
S33493Medicare UPIN