Individual
STACI LYNN ERVIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
1021 NEBRASKA ST, SIOUX CITY, IA 51105-1436
(712) 252-2477
(712) 252-5920
Mailing address
1021 NEBRASKA ST, SIOUX CITY, IA 51105-1436
(712) 252-2477
(712) 252-5920
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
111449
NE
363LF0000X
Family Nurse Practitioner
Primary
A110802
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
111449
LICENSE
NE
01
—
A110802
LICENSE
IA
Enumeration date
12/13/2012
Last updated
06/14/2021
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