Individual
MEGAN L STUKENHOLTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP, PMHNP-BC
Contact information
Practice address
2815 100TH ST # 113, URBANDALE, IA 50322-3860
(515) 344-7755
(515) 809-3855
Mailing address
16174 150TH ST, PERRY, IA 50220-6211
(515) 344-7755
(515) 809-3855
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
118802
IA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
118802
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1629331848
—
IA
01
—
P01353127
RR MEDICARE
IA
Enumeration date
06/21/2012
Last updated
05/31/2024
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