Basic Information
| Provider Information | |||||||||
| NPI: | 1609431501 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | STEFFEN | ||||||||
| FirstName: | DANI | ||||||||
| MiddleName: | DOLORES | ||||||||
| NamePrefix: | MRS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | DC | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | JOHNSON | ||||||||
| OtherFirstName: | DANI | ||||||||
| OtherMiddleName: | DOLORES | ||||||||
| OtherNamePrefix: | MISS | ||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | |||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 13100 KANSAS AVE STE H | ||||||||
| Address2: | |||||||||
| City: | BONNER SPRINGS | ||||||||
| State: | KS | ||||||||
| PostalCode: | 660129296 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9137454036 | ||||||||
| FaxNumber: | 7852719257 | ||||||||
| Practice Location | |||||||||
| Address1: | 13100 KANSAS AVE STE H | ||||||||
| Address2: | |||||||||
| City: | BONNER SPRINGS | ||||||||
| State: | KS | ||||||||
| PostalCode: | 660129296 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9137454036 | ||||||||
| FaxNumber: | 8442738029 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/06/2019 | ||||||||
| LastUpdateDate: | 04/08/2022 | ||||||||
| NPIDeactivationReasonCode: | |||||||||
| NPIDeactivationDate: | |||||||||
| NPIReactivationDate: | |||||||||
| ProviderGenderCode: | F | ||||||||
| AuthorizedOfficialLastName: | |||||||||
| AuthorizedOfficialFirstName: | |||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | |||||||||
| AuthorizedOfficialTelephone: | |||||||||
| IsSoleProprietor: | N | ||||||||
| IsOrganizationSubpart: | |||||||||
| ParentOrganizationLBN: | |||||||||
| AuthorizedOfficialNamePrefix: | |||||||||
| AuthorizedOfficialNameSuffix: | |||||||||
| AuthorizedOfficialCredential: | |||||||||
| NPICertificationDate: | 04/08/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 111N00000X | 01-05976 | KS | Y | Chiropractic Providers | Chiropractor |
No ID Information.