Individual
STACY N. HENNIGAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
4020 MERLE HAY RD STE 100, DES MOINES, IA 50310-1357
(515) 278-0949
(515) 278-6721
Mailing address
5160 SYCAMORE DR, PLEASANT HILL, IA 50327-1978
(515) 205-5871
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
A105594
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1487194791
NPI NUMBER
IA
01
—
A105594
IOWA LICENSE
IA
Enumeration date
03/06/2017
Last updated
05/29/2024
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