Individual
RENEE STAUDACHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
108 N JEFFERSON WAY, INDIANOLA, IA 50125-2616
(515) 961-8448
(515) 643-9100
Mailing address
1055 6TH AVE, SUITE 200, DES MOINES, IA 50314-2607
(515) 643-8672
(515) 643-2784
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
02422
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0057687
—
IA
Enumeration date
08/03/2006
Last updated
07/08/2007
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