Healthcare Provider Details

I. General information

NPI: 1598696031
Provider Name (Legal Business Name): STEPHANIE BERKENPAS RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/26/2026
Last Update Date: 05/26/2026
Certification Date: 05/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 1ST AVE E
SPENCER IA
51301-4342
US

IV. Provider business mailing address

1237 W 11TH ST
SPENCER IA
51301-2907
US

V. Phone/Fax

Practice location:
  • Phone: 712-264-6101
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WE0003X
TaxonomyEmergency Registered Nurse
License Number157700
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: