Individual
STEPHANIE ANNE FARDAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1025 SE TALLGRASS LN STE 220, WAUKEE, IA 50263-6817
(515) 875-9290
Mailing address
PO BOX 424, DES MOINES, IA 50302-0424
(515) 875-9255
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
A173477
IA
Other
Enumeration date
03/02/2023
Last updated
10/15/2024
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