Healthcare Provider Details

I. General information

NPI: 1790646792
Provider Name (Legal Business Name): STACY LYNN ROCK
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/19/2025
Last Update Date: 11/19/2025
Certification Date: 11/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 HIGHWAY 6 W
IOWA CITY IA
52246-2209
US

IV. Provider business mailing address

601 HIGHWAY 6 W
IOWA CITY IA
52246-2209
US

V. Phone/Fax

Practice location:
  • Phone: 319-339-0581
  • Fax: 319-339-7132
Mailing address:
  • Phone: 319-338-0581
  • Fax: 319-339-7132

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WW0101X
TaxonomyAmbulatory Women's Health Care Registered Nurse
License Number092809
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: