Healthcare Provider Details

I. General information

NPI: 1487545174
Provider Name (Legal Business Name): MICHELE LEE STOVER ARNP-FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/11/2025
Last Update Date: 07/11/2025
Certification Date: 07/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1550 6TH ST
MANNING IA
51455-1004
US

IV. Provider business mailing address

1550 6TH ST
MANNING IA
51455-1004
US

V. Phone/Fax

Practice location:
  • Phone: 712-655-2072
  • Fax:
Mailing address:
  • Phone: 712-655-2072
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberA185591
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: