Individual
STACY JO HUCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP-PC, ARNP
Contact information
Practice address
312 9TH ST SW, WAVERLY, IA 50677-2929
(319) 352-4120
Mailing address
1139 130TH ST, PLAINFIELD, IA 50666-9652
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
C155255
IA
Other
Enumeration date
08/03/2019
Last updated
09/13/2019
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