Basic Information
| Provider Information | |||||||||
| NPI: | 1356447189 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | E.DIANE STEEVES ENTERPRISES, INC | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | NEW MEDICAL HEALTH CARE-HALSTEAD | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 126 MAIN ST | ||||||||
| Address2: | PO BOX 55 | ||||||||
| City: | HALSTEAD | ||||||||
| State: | KS | ||||||||
| PostalCode: | 670561708 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3168353700 | ||||||||
| FaxNumber: | 3168353701 | ||||||||
| Practice Location | |||||||||
| Address1: | 126 MAIN ST | ||||||||
| Address2: | |||||||||
| City: | HALSTEAD | ||||||||
| State: | KS | ||||||||
| PostalCode: | 670561708 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3168353700 | ||||||||
| FaxNumber: | 3168353701 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/16/2006 | ||||||||
| LastUpdateDate: | 10/05/2007 | ||||||||
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| ProviderGenderCode: | |||||||||
| AuthorizedOfficialLastName: | STEEVES | ||||||||
| AuthorizedOfficialFirstName: | EUGENIA | ||||||||
| AuthorizedOfficialMiddleName: | DIANE | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 3168353700 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
| ParentOrganizationLBN: | |||||||||
| AuthorizedOfficialNamePrefix: | MS. | ||||||||
| AuthorizedOfficialNameSuffix: | |||||||||
| AuthorizedOfficialCredential: | RN, ARNP | ||||||||
| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 160996 | 01 | KS | BC BS | OTHER |