Healthcare Provider Details

I. General information

NPI: 1386390706
Provider Name (Legal Business Name): LAURA MARIE STENSLAND ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/24/2022
Last Update Date: 10/11/2023
Certification Date: 10/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21923 US HIGHWAY 65
COLO IA
50056-8547
US

IV. Provider business mailing address

21923 US HIGHWAY 65
COLO IA
50056-8547
US

V. Phone/Fax

Practice location:
  • Phone: 515-689-7479
  • Fax:
Mailing address:
  • Phone: 515-689-7479
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberA167082
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: