Provider Demographics
NPI:1366954810
Name:STEFFAN, MARY CATHERINE (NP-C)
Entity type:Individual
Prefix:MRS
First Name:MARY
Middle Name:CATHERINE
Last Name:STEFFAN
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:MARY
Other - Middle Name:CATHERINE
Other - Last Name:SHIVELY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP-C
Mailing Address - Street 1:1405 STANDING STONE WAY
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:OH
Mailing Address - Zip Code:43130-7630
Mailing Address - Country:US
Mailing Address - Phone:419-434-0522
Mailing Address - Fax:
Practice Address - Street 1:111 S MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:OH
Practice Address - Zip Code:43130-4361
Practice Address - Country:US
Practice Address - Phone:740-653-2631
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-24
Last Update Date:2018-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.021923363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily