Basic Information
| Provider Information | |||||||||
| NPI: | 1710576178 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | STECKER | ||||||||
| FirstName: | STEPHANIE | ||||||||
| MiddleName: | ANN | ||||||||
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| Credential: | CNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 634 WALNUT ST | ||||||||
| Address2: | |||||||||
| City: | LEETONIA | ||||||||
| State: | OH | ||||||||
| PostalCode: | 444319770 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3302611919 | ||||||||
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| Practice Location | |||||||||
| Address1: | 5760 PATRIOT BLVD | ||||||||
| Address2: | |||||||||
| City: | AUSTINTOWN | ||||||||
| State: | OH | ||||||||
| PostalCode: | 445151170 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3309530243 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 01/11/2021 | ||||||||
| LastUpdateDate: | 01/25/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 01/25/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163WP0807X | RN277308 | OH | N | Nursing Service Providers | Registered Nurse | Psych/Mental Health, Child & Adolescent | 363LP0808X | APRN.CNP.0028272 | OH | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Psych/Mental Health |
No ID Information.