Healthcare Provider Details

I. General information

NPI: 1952565251
Provider Name (Legal Business Name): STEPHANIE KLEIN ARNP, CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/15/2008
Last Update Date: 10/23/2020
Certification Date: 10/23/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

350 N GRANDVIEW AVE
DUBUQUE IA
52001-6388
US

IV. Provider business mailing address

8324 TURKEY VALLEY LN
DUBUQUE IA
52003-9704
US

V. Phone/Fax

Practice location:
  • Phone: 563-589-2448
  • Fax:
Mailing address:
  • Phone: 563-543-5669
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberD-114338
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: