Healthcare Provider Details

I. General information

NPI: 1447781448
Provider Name (Legal Business Name): STEPHANIE MOON ARNP, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/22/2017
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

846 9TH AVE SE
CEDAR RAPIDS IA
52401-2111
US

IV. Provider business mailing address

846 9TH AVE SE
CEDAR RAPIDS IA
52401-2111
US

V. Phone/Fax

Practice location:
  • Phone: 319-832-2328
  • Fax: 319-832-1168
Mailing address:
  • Phone: 319-832-2328
  • Fax: 319-832-1168

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberA131906
License Number StateIA
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA131906
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: