Individual
STEPHANIE WITHEROW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
500 W RIVER DR, DAVENPORT, IA 52801-1014
(563) 336-3000
(563) 336-3125
Mailing address
500 W RIVER DR, DAVENPORT, IA 52801-1014
(563) 336-3000
(563) 336-3125
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
115535
IA
363LF0000X
Family Nurse Practitioner
Primary
A115535
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1932193224
—
IA
Enumeration date
07/28/2014
Last updated
02/06/2018
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