Provider Demographics
NPI:1831204460
Name:STEENSON, ANDREA J (MD)
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:J
Last Name:STEENSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2500 CALIFORNIA PLZ
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68178-0133
Mailing Address - Country:US
Mailing Address - Phone:402-955-3841
Mailing Address - Fax:402-955-4184
Practice Address - Street 1:8200 DODGE ST
Practice Address - Street 2:SUITE 220
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68114-4113
Practice Address - Country:US
Practice Address - Phone:402-955-3841
Practice Address - Fax:402-955-4174
Is Sole Proprietor?:No
Enumeration Date:2006-08-21
Last Update Date:2016-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE149542080P0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0006XAllopathic & Osteopathic PhysiciansPediatricsDevelopmental - Behavioral Pediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE096270Medicare PIN
NEE07855Medicare UPIN