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Individual

MRS. STACEY ELIZABETH BURMEISTER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
201 RIDGE ST, SUITE 206, COUNCIL BLUFFS, IA 51503-4643
(712) 396-7460
(712) 396-7465
Mailing address
933 E PIERCE ST, SUITE 206, COUNCIL BLUFFS, IA 51503-4626
(712) 396-7460
(712) 396-7465

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
34953
IA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
10025873100
NE
01
1588656003
WELLMARK
IA
05
1588656003
IA
Enumeration date
08/19/2005
Last updated
09/18/2013
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