Healthcare Provider Details

I. General information

NPI: 1750845954
Provider Name (Legal Business Name): STEPHANIE ANNE GIESLER PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/22/2019
Last Update Date: 12/05/2023
Certification Date: 12/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3251 W 9TH ST
WATERLOO IA
50702-5310
US

IV. Provider business mailing address

3251 W 9TH ST
WATERLOO IA
50702-5310
US

V. Phone/Fax

Practice location:
  • Phone: 319-234-2893
  • Fax: 319-234-0354
Mailing address:
  • Phone: 319-234-2893
  • Fax: 319-234-0354

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberG154342
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: