Basic Information
Provider Information
NPI: 1548421639
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: STEELE
FirstName: JAMES
MiddleName: GREGORY
NamePrefix:  
NameSuffix:  
Credential: FNP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2145 5TH AVE
Address2:  
City: OROVILLE
State: CA
PostalCode: 959655870
CountryCode: US
TelephoneNumber: 5305345394
FaxNumber: 5305343820
Practice Location
Address1: 2145 5TH AVE
Address2:  
City: OROVILLE
State: CA
PostalCode: 959655870
CountryCode: US
TelephoneNumber: 5305345394
FaxNumber: 5305343820
Other Information
ProviderEnumerationDate: 06/20/2008
LastUpdateDate: 04/29/2014
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LF0000XFNP 14971CAY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily

ID Information
IDTypeStateIssuerDescription
154842163901 NPIOTHER


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