Individual
STACY ROTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
500 W RIVER DR, DAVENPORT, IA 52801-1014
(563) 336-3000
Mailing address
500 W RIVER DR, DAVENPORT, IA 52801-1014
(563) 336-3000
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
G106548
IA
Other
Enumeration date
09/30/2014
Last updated
10/20/2025
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