Healthcare Provider Details

I. General information

NPI: 1104756261
Provider Name (Legal Business Name): KIANA STANEK DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/21/2026
Last Update Date: 05/21/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 E UNIVERSITY AVE
DES MOINES IA
50316-2392
US

IV. Provider business mailing address

1237 S 52ND ST UNIT 805
WEST DES MOINES IA
50265-5470
US

V. Phone/Fax

Practice location:
  • Phone: 515-265-1050
  • Fax:
Mailing address:
  • Phone: 319-431-7689
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberR-13827
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: