Provider Demographics
NPI:1053035360
Name:STECKLER, JOANNA
Entity type:Individual
Prefix:
First Name:JOANNA
Middle Name:
Last Name:STECKLER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:623 CENTER ST S
Mailing Address - Street 2:
Mailing Address - City:WAHPETON
Mailing Address - State:ND
Mailing Address - Zip Code:58075-4754
Mailing Address - Country:US
Mailing Address - Phone:016-408-2797
Mailing Address - Fax:
Practice Address - Street 1:623 CENTER ST S
Practice Address - Street 2:
Practice Address - City:WAHPETON
Practice Address - State:ND
Practice Address - Zip Code:58075-4754
Practice Address - Country:US
Practice Address - Phone:016-408-2797
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-29
Last Update Date:2022-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant