Provider Demographics
NPI:1174895262
Name:STECKLEIN, TARA Z (PA-C)
Entity type:Individual
Prefix:
First Name:TARA
Middle Name:Z
Last Name:STECKLEIN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:TARA
Other - Middle Name:
Other - Last Name:ZABAWA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:P.O. BOX 2290
Mailing Address - Street 2:
Mailing Address - City:KEARNEY
Mailing Address - State:NE
Mailing Address - Zip Code:68848
Mailing Address - Country:US
Mailing Address - Phone:308-785-8560
Mailing Address - Fax:308-865-2765
Practice Address - Street 1:620 EAST 25TH STREET
Practice Address - Street 2:
Practice Address - City:KEARNEY
Practice Address - State:NE
Practice Address - Zip Code:68847-5511
Practice Address - Country:US
Practice Address - Phone:308-865-2767
Practice Address - Fax:308-865-2765
Is Sole Proprietor?:No
Enumeration Date:2012-02-03
Last Update Date:2025-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1501514363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical