Provider Demographics
NPI:1033924139
Name:STEINBERG, MADISON KENNEDY (ACNPC-AG)
Entity type:Individual
Prefix:
First Name:MADISON
Middle Name:KENNEDY
Last Name:STEINBERG
Suffix:
Gender:F
Credentials:ACNPC-AG
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:121 SAINT LUKES CENTER DR STE 404
Mailing Address - Street 2:BUILDING A
Mailing Address - City:CHESTERFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:63017-3519
Mailing Address - Country:US
Mailing Address - Phone:314-864-8720
Mailing Address - Fax:
Practice Address - Street 1:121 SAINT LUKES CENTER DR STE 404
Practice Address - Street 2:BUILDING A
Practice Address - City:CHESTERFIELD
Practice Address - State:MO
Practice Address - Zip Code:63017-3519
Practice Address - Country:US
Practice Address - Phone:314-864-8720
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-07
Last Update Date:2025-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2025003529363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute CareGroup - Single Specialty