Individual
BETHANY STAFFORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1825 LOGAN AVE, SUITE 201, WATERLOO, IA 50703-1916
(319) 235-3838
(319) 235-5272
Mailing address
1825 LOGAN AVE, SUITE 201, WATERLOO, IA 50703-1916
(319) 235-3838
(319) 235-5272
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
H-121407
IA
363LA2100X
Acute Care Nurse Practitioner
Primary
H-121407
IA
Other
Enumeration date
08/28/2016
Last updated
07/16/2025
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