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Individual

NICOLE MARIE STALL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP-C

Contact information

Practice address
3205 ZENITH AVE UNIT 2, SPIRIT LAKE, IA 51360-1084
(319) 400-3085
Mailing address
3205 ZENITH AVE UNIT 2, SPIRIT LAKE, IA 51360-1084
(319) 400-3085
(712) 215-6944

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
A110196
IA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
A110196
LICENSE
IA
Enumeration date
02/12/2010
Last updated
06/05/2025
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