Healthcare Provider Details

I. General information

NPI: 1578766028
Provider Name (Legal Business Name): STEPHANIE JEAN TURCOTTE D.O
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/11/2007
Last Update Date: 01/27/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1111 6TH AVE
DES MOINES IA
50314-2613
US

IV. Provider business mailing address

PO BOX 4925
DES MOINES IA
50305-4925
US

V. Phone/Fax

Practice location:
  • Phone: 515-247-3211
  • Fax: 515-643-8933
Mailing address:
  • Phone: 515-247-3211
  • Fax: 515-643-8933

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number125-049407
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: