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TIFFANY C STECKLEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
929 N SAINT FRANCIS ST, WICHITA, KS 67214-3821
(800) 374-5326
(800) 374-7656
Mailing address
PO BOX 356, WICHITA, KS 67201-0356
(800) 374-5326
(800) 374-7656

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
1499722072
KS
163W00000X
Registered Nurse
707588
TX
367500000X
Certified Registered Nurse Anesthetist
139538
KS
367500000X
Certified Registered Nurse Anesthetist
Primary
556904
KS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200623270A
KS
01
P00795821
RR MEDICARE GROUP CQ2302
KS
Enumeration date
06/11/2009
Last updated
03/25/2010
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