Individual
STEPHANIE ELLSWORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
3426 N PORT DR STE 100, MUSCATINE, IA 52761-2242
(563) 262-4101
Mailing address
200 HAWKINS DRIVE, DEPARTMENT OF INTERNAL MEDICINE, IOWA CITY, IA 52242-1009
(319) 356-1616
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
A132211
IA
363LF0000X
Family Nurse Practitioner
A132211
IA
Other
Enumeration date
06/16/2016
Last updated
09/14/2017
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