Provider Demographics
NPI:1902553506
Name:THOMAS, STEFFANEY KATHLEEN (APRN, CNM)
Entity Type:Individual
Prefix:MRS
First Name:STEFFANEY
Middle Name:KATHLEEN
Last Name:THOMAS
Suffix:
Gender:F
Credentials:APRN, CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 CLIFF CT
Mailing Address - Street 2:
Mailing Address - City:NORTH MANKATO
Mailing Address - State:MN
Mailing Address - Zip Code:56003-3303
Mailing Address - Country:US
Mailing Address - Phone:608-577-7371
Mailing Address - Fax:
Practice Address - Street 1:109 CLIFF CT
Practice Address - Street 2:
Practice Address - City:NORTH MANKATO
Practice Address - State:MN
Practice Address - Zip Code:56003-3303
Practice Address - Country:US
Practice Address - Phone:608-577-7371
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-04
Last Update Date:2022-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN457367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife