Healthcare Provider Details

I. General information

NPI: 1053372029
Provider Name (Legal Business Name): STEFANIE YEARIAN ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/30/2006
Last Update Date: 05/02/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1229 C AVE E
OSKALOOSA IA
52577-4246
US

IV. Provider business mailing address

1229 C AVE E
OSKALOOSA IA
52577-4246
US

V. Phone/Fax

Practice location:
  • Phone: 641-672-3259
  • Fax: 641-672-3259
Mailing address:
  • Phone: 641-672-3259
  • Fax: 641-672-3259

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number683531
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberG103121
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: