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Individual
KAREN S STAACK
Active
Individual
KAREN S STAACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
21481
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0550095
MEDIPASS
IA
01
—
1831161587
NPI
—
01
—
21481
LICENSE
NE
05
—
470710146-13
—
NE
Enumeration date
02/06/2006
Last updated
03/07/2023
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