Basic Information
Provider Information
NPI: 1356808869
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: STEIMLE
FirstName: JASON
MiddleName: ALLEN
NamePrefix:  
NameSuffix:  
Credential: CRNA
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 2897
Address2:  
City: WICHITA
State: KS
PostalCode: 672012897
CountryCode: US
TelephoneNumber: 8444689498
FaxNumber: 8556301302
Practice Location
Address1: 929 N SAINT FRANCIS ST
Address2:  
City: WICHITA
State: KS
PostalCode: 672143821
CountryCode: US
TelephoneNumber: 3162685000
FaxNumber: 3162914272
Other Information
ProviderEnumerationDate: 02/21/2019
LastUpdateDate: 09/13/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
163W00000X9440752FLN Nursing Service ProvidersRegistered Nurse 
163W00000X13124782052KSN Nursing Service ProvidersRegistered Nurse 
367500000X557719KSY Physician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered 

No ID Information.


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